Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK

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 10bpm 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.

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Identifiers

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

ORCID for Nicholas Harvey: orcid.org/0000-0002-8194-2512

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