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

Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK
Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK
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.
1932-6203
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Cooper, Jackie
f78de577-4cac-496f-ad11-5f59dd305046
Judge, Rebekah
2833f417-2be6-42db-9677-8667a90c3e2c
Khanji, Mohammed Y.
fcc9f8c6-b352-4870-8fe0-9ab6676cff86
Munroe, Patricia B.
44d23746-20cd-4572-860e-7350424cc031
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928
Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Cooper, Jackie
f78de577-4cac-496f-ad11-5f59dd305046
Judge, Rebekah
2833f417-2be6-42db-9677-8667a90c3e2c
Khanji, Mohammed Y.
fcc9f8c6-b352-4870-8fe0-9ab6676cff86
Munroe, Patricia B.
44d23746-20cd-4572-860e-7350424cc031
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928

Raisi-Estabragh, Zahra, Cooper, Jackie, Judge, Rebekah, Khanji, Mohammed Y., Munroe, Patricia B., Cooper, Cyrus, Harvey, Nicholas and Petersen, Steffen E. (2020) Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK. PLoS ONE. (In Press)

Record type: Article

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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Accepted/In Press date: 15 May 2020

Identifiers

Local EPrints ID: 440959
URI: http://eprints.soton.ac.uk/id/eprint/440959
ISSN: 1932-6203
PURE UUID: 46ba52d1-2fcb-48df-aade-ec9b78cbed19
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 26 May 2020 16:30
Last modified: 07 Oct 2020 01:49

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Contributors

Author: Zahra Raisi-Estabragh
Author: Jackie Cooper
Author: Rebekah Judge
Author: Mohammed Y. Khanji
Author: Patricia B. Munroe
Author: Cyrus Cooper ORCID iD
Author: Nicholas Harvey ORCID iD
Author: Steffen E. Petersen

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