Resting heart rate and risk of type 2 diabetes in women.
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.
Zhang
Xianglan
X
Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA. xianglan.zhang@vanderbilt.edu
Shu
Xiao-Ou
XO
Xiang
Yong-Bing
YB
Yang
Gong
G
Li
Honglan
H
Cai
Hui
H
Gao
Yu-Tang
YT
Zheng
Wei
W
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
Hypertension. 2007 Jan;49(1):27-33
17116758
Diabetes Care. 2003 Nov;26(11):3035-41
14578236
Diabetes Care. 2006 Apr;29(4):914-9
16567837
Diabetes Care. 1997 Jul;20(7):1183-97
9203460
Diabetes Care. 2008 Feb;31(2):335-9
17959868
J Hypertens. 2008 Aug;26(8):1540-5
18622227
Diabetes Care. 2004 Feb;27(2):354-61
14747213
J Clin Endocrinol Metab. 1999 Apr;84(4):1263-7
10199765
Epidemiol Rev. 2007;29:115-28
17494056
Eur Heart J. 2004 Mar;25(5):363-70
15033247
Am J Hypertens. 2009 Feb;22(2):151-5
19151693
Am J Epidemiol. 1999 May 1;149(9):853-62
10221322
Diabetes Care. 2006 Jul;29(7):1585-90
16801583
Am J Epidemiol. 2005 Dec 1;162(11):1123-31
16236996
BMJ. 2009 Feb 03;338:b219
19193613
J Hypertens. 2007 May;25(5):909-20
17414649
Arch Intern Med. 2007 May 14;167(9):886-92
17502529
Am J Epidemiol. 2003 Dec 1;158(11):1114-22
14630608
Eur Heart J. 2007 Dec;28(23):2937-43
17925342
J Am Coll Cardiol. 2007 Aug 28;50(9):823-30
17719466
J Am Coll Cardiol. 2008 May 6;51(18):1725-33
18452777
Circulation. 2003 May 6;107(17):2190-5
12695289
Arch Intern Med. 2002 Nov 11;162(20):2313-21
12418945