title: Resting heart rate and risk of type 2 diabetes in women.
abstract: BACKGROUND
  Resting heart rate has been shown to predict risk of cardiovascular disease; its association with diabetes remains unclear, particularly in non-Western populations.
  
  
  METHODS
  We evaluated the association between resting heart rate and risk of type 2 diabetes in the Shanghai Women's Health Study, a population-based prospective cohort study. The analysis included 47 571 Chinese women with no prior history of diabetes, cancer, cardiovascular disease or thyroid dysfunction at the time when resting heart rate was measured. Incident diabetes was ascertained through biennial in-person interviews.
  
  
  RESULTS
  During a mean follow-up of 4.9 years, 849 women developed type 2 diabetes. For heart rate categories of < or =68, 69-72, 73-76, 77-80 and >80 beats/min, the incidence rates of diabetes per 1000 person-years were 2.91, 3.31, 3.71, 4.16 and 5.34, respectively. The multivariable-adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] for diabetes across increasing heart rate categories were 1, 1.21 (0.99-1.47), 1.30 (1.05-1.62), 1.37 (1.12-1.69) and 1.60 (1.28-2.00), respectively. Further analyses of the joint effects of heart rate with body mass index (BMI), waist-hip ratio (WHR) and blood pressure (BP) showed increased risk of diabetes with increasing heart rate in all categories of BMI, WHR or BP. The combinations of the highest heart rate category with highest BMI, WHR or BP category were associated with the highest HRs, ranging from 4.81 to 6.34.
  
  
  CONCLUSIONS
  A high resting heart rate is independently associated with an increased risk of type 2 diabetes in women. The combinations of high heart rate with high BMI, WHR or BP level are associated with a substantially increased risk.
authors.affiliation: Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA. xianglan.zhang@vanderbilt.edu
authors.forename: Xianglan
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.forename: Gong
authors.initials: G
authors.lastname: Yang
authors.forename: Honglan
authors.initials: H
authors.lastname: Li
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
mesh_terms: D000368:Aged; D044466:Asian People; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D049629:Waist-Hip Ratio
references.citation: Hypertension. 2007 Jan;49(1):27-33
references.pmid: 17116758
references.citation: Diabetes Care. 2003 Nov;26(11):3035-41
references.pmid: 14578236
references.citation: Diabetes Care. 2006 Apr;29(4):914-9
references.pmid: 16567837
references.citation: Diabetes Care. 1997 Jul;20(7):1183-97
references.pmid: 9203460
references.citation: Diabetes Care. 2008 Feb;31(2):335-9
references.pmid: 17959868
references.citation: J Hypertens. 2008 Aug;26(8):1540-5
references.pmid: 18622227
references.citation: Diabetes Care. 2004 Feb;27(2):354-61
references.pmid: 14747213
references.citation: J Clin Endocrinol Metab. 1999 Apr;84(4):1263-7
references.pmid: 10199765
references.citation: Epidemiol Rev. 2007;29:115-28
references.pmid: 17494056
references.citation: Eur Heart J. 2004 Mar;25(5):363-70
references.pmid: 15033247
references.citation: Am J Hypertens. 2009 Feb;22(2):151-5
references.pmid: 19151693
references.citation: Am J Epidemiol. 1999 May 1;149(9):853-62
references.pmid: 10221322
references.citation: Diabetes Care. 2006 Jul;29(7):1585-90
references.pmid: 16801583
references.citation: Am J Epidemiol. 2005 Dec 1;162(11):1123-31
references.pmid: 16236996
references.citation: BMJ. 2009 Feb 03;338:b219
references.pmid: 19193613
references.citation: J Hypertens. 2007 May;25(5):909-20
references.pmid: 17414649
references.citation: Arch Intern Med. 2007 May 14;167(9):886-92
references.pmid: 17502529
references.citation: Am J Epidemiol. 2003 Dec 1;158(11):1114-22
references.pmid: 14630608
references.citation: Eur Heart J. 2007 Dec;28(23):2937-43
references.pmid: 17925342
references.citation: J Am Coll Cardiol. 2007 Aug 28;50(9):823-30
references.pmid: 17719466
references.citation: J Am Coll Cardiol. 2008 May 6;51(18):1725-33
references.pmid: 18452777
references.citation: Circulation. 2003 May 6;107(17):2190-5
references.pmid: 12695289
references.citation: Arch Intern Med. 2002 Nov 11;162(20):2313-21
references.pmid: 12418945