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Heart rate, mortality, and the relation with clinical and subclinical cardiovascular diseases: results from the Gutenberg Health Study.


ABSTRACT: BACKGROUND:Higher, but also lower resting heart rate (HR), has been associated with increased cardiovascular events and mortality. Little is known about the interplay between HR, cardiovascular risk factors, concomitant diseases, vascular (endothelial) function, neurohormonal biomarkers, and all-cause mortality in the general population. Thus, we aimed to investigate these relationships in a population-based cohort. METHODS:15,010 individuals (aged 35-74 at enrolment in 2007-2012) from the Gutenberg Health Study were analyzed. Multivariable regression modeling was used to assess the relation between the variables and conditional density plots were generated for cardiovascular risk factors, diseases, and mortality to show their dependence on HR. RESULTS:There were 714 deaths in the total sample at 7.67?±?1.68 years of follow-up. The prevalence of diabetes mellitus, arterial hypertension, coronary and peripheral artery disease, chronic heart failure, and previous myocardial infarction exhibited a J-shaped association with HR. Mortality showed a similar relation with a nadir of 64 beats per minute (bpm) in the total sample. Each 10 bpm HR reduction in HR??64 subjects (Hazard Ratio 1.29; 95% confidence interval 1.19-1.41 per 10 bpm increase in HR). Results found for vascular and neurohormonal biomarkers exhibited a differential picture in subjects with a HR below and above the nadir. DISCUSSION:These results indicate that in addition to a higher HR, a lower HR is associated with increased mortality.

SUBMITTER: Munzel T 

PROVIDER: S-EPMC6868108 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Heart rate, mortality, and the relation with clinical and subclinical cardiovascular diseases: results from the Gutenberg Health Study.

Münzel Thomas T   Hahad Omar O   Gori Tommaso T   Hollmann Sebastian S   Arnold Natalie N   Prochaska Jürgen H JH   Schulz Andreas A   Beutel Manfred M   Pfeiffer Norbert N   Schmidtmann Irene I   Lackner Karl J KJ   Keaney John F JF   Wild Philipp S PS  

Clinical research in cardiology : official journal of the German Cardiac Society 20190405 12


<h4>Background</h4>Higher, but also lower resting heart rate (HR), has been associated with increased cardiovascular events and mortality. Little is known about the interplay between HR, cardiovascular risk factors, concomitant diseases, vascular (endothelial) function, neurohormonal biomarkers, and all-cause mortality in the general population. Thus, we aimed to investigate these relationships in a population-based cohort.<h4>Methods</h4>15,010 individuals (aged 35-74 at enrolment in 2007-2012)  ...[more]

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