Dr. Zahra Raisi-Estabragh and colleagues summarize a very LARGE cohort study of over 500,000 individuals in the UK Biobank. Entering my 40s has caused me to consider careful monitoring of many health indicators including my resting heart rate. The authors concluded that with each increase in 10 beats per minute (bpm) there was a 22% and 17%, in males and females respectively, rise in all cause cardiovascular disease. Additional metrics for cancer mortality were also measured. A link to the full article published last week in the Public Library of Science (PLOS ONE) open-access journal can be accessed here. Another interesting but unrelated PLOS ONE article (and blast from the past of 2011) can be accessed here.
The authors conclude:
”RHR is an independent predictor of mortality, with variation by sex, age, and disease. Ischaemic disease appeared a more important driver of this relationship in men, and associations were more pronounced at younger ages.”
AUTHORS: Zahra Raisi-Estabragh, Jackie Cooper, Rebekah Judge, Mohammed Y. Khanji, Patricia B. Munroe, Cyrus Cooper, Nicholas C. Harvey, Steffen E. Petersen
ABSTRACT:
OBJECTIVE:
To define the sex, age, and disease-specific associations of resting heart rate (RHR) with cardiovascular and mortality outcomes in 502,534 individuals from the UK Biobank over 7–12 years of prospective follow-up.
METHODS:
The main outcomes were all-cause, cardiovascular, and ischaemic heart disease mortality. Additional outcomes included incident acute myocardial infarction (AMI), fatal AMI, and cancer mortality. We considered a wide range of confounders and the effects of competing hazards. Results are reported as hazard ratios (HR) for all-cause mortality and sub-distribution hazard ratios (SHR) for other outcomes with corresponding 95% confidence intervals (CI) per 10bpm increment of RHR.
RESULTS:
In men, for every 10 bpm increase of RHR there was 22% (HR 1.22, CI 1.20 to 1.24, p = 3×10−123) greater hazard of all-cause and 17% (SHR 1.17, CI 1.13 to 1.21, p = 5.6×10−18) greater hazard of cardiovascular mortality; for women, corresponding figures were 19% (HR 1.19, CI 1.16 to 1.22, p = 8.9×10−45) and 14% (SHR 1.14, CI 1.07 to 1.22, p = 0.00008). Associations between RHR and ischaemic outcomes were of greater magnitude amongst men than women, but with similar magnitude of association for non-cardiovascular cancer mortality [men (SHR 1.18, CI 1.15–1.21, p = 5.2×10−46); women 15% (SHR 1.15, CI 1.11–1.18, p = 3.1×10−18)]. Associations with all-cause, incident AMI, and cancer mortality were of greater magnitude at younger than older ages.
CONCLUSIONS:
RHR is an independent predictor of mortality, with variation by sex, age, and disease. Ischaemic disease appeared a more important driver of this relationship in men, and associations were more pronounced at younger ages.
ABOUT THE AUTHORS:
Zahra Raisi-Estabragh
ROLES Conceptualization, Investigation, Methodology, Writing – original draft, Writing – review & editing
AFFILIATIONS William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom, Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
http://orcid.org/0000-0002-7757-5465
Jackie Cooper
ROLES Data curation, Formal analysis, Methodology, Software, Writing – review & editing
AFFILIATIONS William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom, Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
Rebekah Judge
ROLES Writing – original draft, Writing – review & editing
AFFILIATION Imperial College Healthcare Trust, St Mary’s Hospital, London, United Kingdom
http://orcid.org/0000-0003-3288-8297
Mohammed Y. Khanji
ROLES Writing – review & editing
AFFILIATIONS William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom, Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
Patricia B. Munroe
ROLES Writing – review & editing
AFFILIATION William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom
Cyrus Cooper
ROLES Writing – review & editing
AFFILIATIONS MRC Lifecourse Epidemiology Unit (MRCLEU), Southampton, United Kingdom, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
Nicholas C. Harvey
ROLES Conceptualization, Methodology, Supervision, Writing – original draft, Writing – review & editing
AFFILIATIONS MRC Lifecourse Epidemiology Unit (MRCLEU), Southampton, United Kingdom, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Steffen E. Petersen
ROLES Conceptualization, Methodology, Supervision, Writing – original draft, Writing – review & editing
* E-mail: s.e.petersen@qmul.ac.uk
AFFILIATIONS William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom, Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
http://orcid.org/0000-0003-4622-5160
Competing Interests
I have read the journal's policy and the authors of this manuscript have the following competing interests: SEP acts as a paid consultant to Circle Cardiovascular Imaging Inc., Calgary, Canada and Servier. NCH has received consultancy, lecture fees, and honoraria from Alliance for Better Bone Health, Amgen, MSD, Eli Lilly, Servier, Shire, Radius Health, UCB, Consilient Healthcare, Kyowa Kirin and Internis Pharma. The remaining authors have nothing to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.