Dataset Information

Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study.

ABSTRACT: OBJECTIVE:Previous studies have shown that an elevated heart rate is associated with a higher risk of cardiovascular events. This study aimed to prospectively examine the relationship between resting heart rate (RHR) and all-cause mortality in Chinese patients with hypertension. DESIGN:An observational, prospective and population-based cohort study. SETTING:The Kailuan cohort study was conducted in Tangshan City in northern China. PARTICIPANTS:We enrolled 46?561 patients who did not receive beta-blocker treatment and were diagnosed with hypertension for the first time during an employee health examination in Kailuan Group in 2006 and 2008. OUTCOME:The primary outcome of this study was all-cause mortality. METHODS:The patients in this study were followed for 9.25±1.63 years. All patients were followed up face to face every 2 years. According to the distribution of RHR in the study population, RHR was categorised into five groups on the basis of quintiles: Q1: RHR ?68?beats per minute (bpm); Q2: RHR >68?and ?72?bpm; Q3: RHR >72?and ?76?bpm; Q4: RHR >76?and ?82?bpm; Q5: RHR >82?bpm. Cox proportional hazards model, which was adjusted for traditional risk factors, was used. RESULTS:During follow-up, 4751 deaths occurred. After adjustment for potential confounders, restricted cubic spline regression showed that the risk of all-cause mortality increased with heart rate. In multivariate Cox regression analyses adjusted for age, sex and major covariates, the HR for all-cause mortality was 1.31 (95% CI 1.27 to 1.33) in the highest quintile group (Q5) compared with the lowest quintile group (Q1). CONCLUSION:An increase in RHR is a long-term risk factor of all-cause mortality in Chinese patients with hypertension. TRIAL REGISTRATION NUMBER:ChiCTR-TNC-11001489.

SUBMITTER: Zhao MX

PROVIDER: S-EPMC7066611 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study.

Zhao Mao Xiang MX Zhao Quanhui Q Zheng Mengyi M Liu Tong T Li Yao Y Wang Miao M Yao Siyu S Wang Chi C Chen Yan-Ming YM Xue Hao H Wu Shouling S

BMJ open 20200310 3

<h4>Objective</h4>Previous studies have shown that an elevated heart rate is associated with a higher risk of cardiovascular events. This study aimed to prospectively examine the relationship between resting heart rate (RHR) and all-cause mortality in Chinese patients with hypertension.<h4>Design</h4>An observational, prospective and population-based cohort study.<h4>Setting</h4>The Kailuan cohort study was conducted in Tangshan City in northern China.<h4>Participants</h4>We enrolled 46 561 pati ...[more]

PMID: 32161155

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Project description:Importance:Higher resting heart rate (RHR) is associated with increased risk of cardiovascular and all-cause mortality. Limited attention has been paid to early-life determinants of life-course RHR. Objective:To describe trajectories of RHR in the same individuals from age 6 to 69 years. Design, Setting, and Participants:Data were from the Medical Research Council National Survey of Health and Development population-based cohort of individuals who were followed up from birth in 1946 until 2015. Analysis was conducted between September 2016 and June 2017. Multilevel models were used to estimate life-course mean RHR trajectory by sex and to investigate associations with early childhood factors. The maximal sample included participants who had at least 1 measure of RHR since study entry and a measure of birth weight (N?=?4779; observations?=?26?182). Exposures:Information on early-life factors was ascertained prospectively: childhood socioeconomic position, birth weight, body mass index (calculated as weight in kilograms divided by height in meters squared) change from age 2 to 6 years (conditioned on body mass index at age 2 years), duration of breastfeeding, and markers of neurodevelopment (age at first walking independently and cognitive ability at age 8 years). Main Outcomes and Measures:Resting heart rate measured on 8 occasions between age 6 and 69 years (3 occasions in childhood and 5 in adulthood). Results:Of 4779 participants, 2492 (52.1%) were women, and 2287 (47.9%) were men. Mean estimated RHR decreased with increasing age and plateaued in adulthood. In sex-adjusted analyses, higher birth weight and conditional body mass index change were associated with lower RHR at age 6 years and across the life course (-0.56 bpm [95% CI, -0.95 to -0.17] per 1 kg higher birth weight and -0.30 bpm [95% CI, -0.48 to -0.13] per 1 kg/m2 change in body mass index). Associations between socioeconomic position and breastfeeding on RHR trajectory emerged in adulthood such that by age 69 years, RHR was 1.48 bpm (95% CI, 0.45 to 2.51) higher in participants from a disadvantaged vs advantaged background and -1.34 bpm (95% CI, -2.39 to -0.29) lower for those who were breastfed for 8 months or longer vs never. A later age at first walking was associated with higher RHR at age 6 years (1.49 bpm [95% CI, 0.39 to 2.59] higher for those 18 months or older vs those younger than 12 months) but with lower RHR in adulthood (-1.18 bpm [95% CI, -2.75 to 0.39] at age 69 years). Conclusions and Relevance:Early life is a key period in determining future RHR trajectories with associations with potentially modifiable factors persisting into the seventh decade of life.

Project description:AimsMicroalbuminuria is an indicator of adverse cardiovascular events and chronic kidney disease. Studies have described an elevated resting heart rate as a risk factor for microalbuminuria in people with cardiovascular disease, but none have clarified its role in microalbuminuria development in people with type 2 diabetes. Therefore, this study investigated the relationship between resting heart rate and new-onset microalbuminuria in type 2 diabetes.MethodsA total of 788 people from a glycaemic control trial in Taiwan were enrolled. Microalbuminuria was defined as a fasting urine albumin-to-creatinine ratio ≥30 mg/g in two consecutive urine tests. Resting heart rate and other covariates were measured at baseline. The quartile of resting heart rates, categorized as <70, 70-74, 75-80 and >80 beats/min, was used for analysis. Cox proportional hazard models were used to evaluate the association between resting heart rate and risk of microalbuminuria.ResultsDuring the follow-up period, 244 people (31%) developed microalbuminuria. Those who developed microalbuminuria had a longer diabetes duration (median = 3.0 vs. 2.0 years, p < 0.001), higher rate of hypertension (77% vs. 66%, p = 0.003), higher rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker treatment (50% vs. 38%, p = 0.001) and higher baseline HbA1c level (70 vs. 64 mmol/mol, 8.6 vs. 8.0%, p < 0.001). After adjusting for demographics, metabolic profiles and inflammatory markers, developing microalbuminuria was significantly associated with baseline resting heart rate of 70-74, 75-80 and >80 beats/min (with hazard ratios [95% CI] of 2.05 [1.32, 3.18], 2.10 [1.32, 3.32] and 1.62 [1.01, 2.59], respectively) compared to resting heart rates <70 beats/min. An average increased risk of microalbuminuria for increment of 10 beats/min was about 24% among those with hypertension (with hazard ratios of 1.24 [1.05, 1.47] in the multivariable Cox model).ConclusionsThis prospective cohort study showed that resting heart rate may be an associative risk factor for developing microalbuminuria in type 2 diabetes.

Dataset Information

Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study.

Publications

Effect of resting heart rate on the risk of all-cause death in Chinese patients with hypertension: analysis of the Kailuan follow-up study.

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