Sex differences in the effect of heart rate on mortality in the elderly.
OBJECTIVE
To examine the association between heart rate and mortality risk in the elderly.


METHODS
Longitudinal cohort.


METHODS
Outpatient.


METHODS
Four hundred twenty-two people, aged 70 upon entry, were surveyed and followed for 6 years.


METHODS
Pulse rate was measured manually, while sitting and standing, and heart rate was measured from electrocardiogram recordings. The population was divided into quartiles of heart rate, with the top quartile comprising those with heart rate greater than 77 beats per minute (bpm) and the bottom quartile those with heart rate less than 60 bpm.


RESULTS
After controlling for possible confounders, there was a clear correlation (r) between heart rate and all-cause mortality in elderly women (r=0.25, P=.0003). The correlation in women was observed using the three different methods for measuring heart rate. Heart rate was associated with all-cause and cardiovascular mortality. There was no relationship between heart rate and level of exercise or smoking status. In multiple regression analysis, the increased risk of death in the women was independent of previous cardiovascular or cerebrovascular disease, hypertension, anemia, congestive heart failure, smoking, and level of exercise or activities of daily living (relative odds ratio (ROR)=3.37, 95% confidence interval (CI)=0.96-11.8). When women using beta-blockers were excluded, this relationship became even stronger (ROR=8.5, 95% CI=1.19-60.1).


CONCLUSIONS
Elevated heart rate is related to increased mortality in elderly women, thus representing a simple index of general health status in this population. Elevated heart rate did not predict mortality in elderly men.
Perk
Gila
G
Department of Internal Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Stessman
Jochanan
J
Ginsberg
Gary
G
Bursztyn
Michael
M
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D015331:Cohort Studies; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006339:Heart Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D016017:Odds Ratio; D010045:Outpatients; D011187:Posture; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors