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April 27, 2011European Journal of Preventive Cardiology133 citationsOpen Access

Resting heart rate is associated with cardiovascular and all-cause mortality after adjusting for inflammatory markers: The Copenhagen City Heart Study

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MJMagnus T. JensenJMJacob Louis MarottKAKristine H. Allin

Key Result

A 10 beats per minute increase in resting heart rate was independently associated with increased cardiovascular (HR 1.14; 95% CI 1.07-1.22) and all-cause mortality (HR 1.09; 95% CI 1.05-1.14).

Key Points

  • To explore the connection between resting heart rate and chronic low-grade inflammation, and its link to mortality.
  • Followed 6518 healthy subjects from the Danish population for 18 years.
  • Assessed resting heart rate, cardiovascular risk factors, hsCRP, and fibrinogen levels.
  • Used uni- and multivariate models to analyze mortality associations.
  • Each 10 beats per minute increase in resting heart rate was linked to higher cardiovascular mortality (HR 1.21, 95% CI 1.14-1.29) and all-cause mortality (HR 1.15, 95% CI 1.11-1.19).
  • Adjusted models still showed significant associations for mortality with RHR: cardiovascular (HR 1.16, 95% CI 1.09-1.24), all-cause (HR 1.10, 95% CI 1.06-1.14).
  • The association remained valid even after adjusting for inflammatory markers hsCRP and fibrinogen.

Study Design

Type

Cohort (n=6,518)

Structured PICO

Is elevated resting heart rate independently associated with cardiovascular and all-cause mortality after adjusting for inflammatory markers in a healthy general population?

P
Population
6,518 healthy subjects from the Danish general population
I
Intervention
Elevated resting heart rate (evaluated per 10 beats per minute increase)
C
Comparator
Lower resting heart rate
O
Outcome
Cardiovascular and all-cause mortalityhard clinical

Resting heart rate is an independent risk factor for cardiovascular and all-cause mortality, and not merely a marker of chronic low-grade inflammation.

Main Result

Effect estimate: HR 1.14 (CV) and HR 1.09 (all-cause) (95% CI 1.07-1.22 (CV) and 1.05-1.14 (all-cause))

Abstract

AIMS: To investigate the association between resting heart rate (RHR) and markers of chronic low-grade inflammation. Also, to examine whether elevated resting heart rate is independently associated with cardiovascular and all-cause mortality in the general population, or whether elevated RHR is merely a marker of chronic low-grade inflammation. METHODS AND RESULTS: A group of 6518 healthy subjects from the the Danish general population were followed for 18 years during which 1924 deaths occurred. Subjects underwent assessment of baseline RHR, conventional cardiovascular risk factors, high-sensitivity C-reactive protein (hsCRP), and fibrinogen. RHR was associated with hsCRP and fibrinogen in uni- and multivariate models (p < 0.0001). A 10 beats per minute increase in RHR was associated with increased cardiovascular and all-cause mortality in univariate models - HR (95%CI) (1.21 (1.14-1.29) and 1.15 (1.11-1.19); multivariate models adjusted for conventional risk factors - 1.16 (1.09-1.24) and 1.10 (1.06-1.14); multivariate models including hsCRP - 1.14 (1.07-1.22) and 1.09 (1.05-1.14); fibrinogen - 1.15 (1.07-1.22) and 1.09 (1.05-1.14); and both hsCRP and fibrinogen - 1.14 (1.07-1.22) and 1.09 (1.05-1.14). CONCLUSION: RHR was associated with markers of chronic low-grade inflammation. However, RHR remained associated with both cardiovascular and all-cause mortality after adjusting for markers of chronic low-grade inflammation. This suggests that RHR is an independent risk factor for cardiovascular and all-cause mortality, and not merely a marker of chronic low-grade inflammation.

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Cite This Study

Jensen et al. (2011) conducted a cohort in Healthy subjects (n=6,518). Resting heart rate was evaluated on Cardiovascular and all-cause mortality (HR 1.14 (CV) and HR 1.09 (all-cause), 95% CI 1.07-1.22 (CV) and 1.05-1.14 (all-cause)). A 10 beats per minute increase in resting heart rate was independently associated with increased cardiovascular (HR 1.14; 95% CI 1.07-1.22) and all-cause mortality (HR 1.09; 95% CI 1.05-1.14).

synapsesocial.com/papers/6a08741a280cd4e998e8c074https://doi.org/10.1177/1741826710394274
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