title: Resting heart rate and the risk of heart failure in healthy adults: the Rotterdam Study.
abstract: BACKGROUND
  An elevated resting heart rate is associated with rehospitalization for heart failure and is a modifiable risk factor in heart failure patients. We aimed to examine the association between resting heart rate and incident heart failure in a population-based cohort study of healthy adults without pre-existing overt heart disease.
  
  
  RESULTS
  We studied 4768 men and women aged ≥55 years from the population-based Rotterdam Study. We excluded participants with prevalent heart failure, coronary heart disease, pacemaker, atrial fibrillation, atrioventricular block, and those using β-blockers or calcium channel blockers. We used extended Cox models allowing for time-dependent variation of resting heart rate along follow-up. During a median of 14.6 years of follow-up, 656 participants developed heart failure. The risk of heart failure was higher in men with higher resting heart rate. For each increment of 10 beats per minute, the multivariable adjusted hazard ratios in men were 1.16 (95% confidence interval, 1.05-1.28; P=0.005) in the time-fixed heart rate model and 1.13 (95% confidence interval, 1.02-1.25; P=0.017) in the time-dependent heart rate model. The association could not be demonstrated in women (P for interaction=0.004). Censoring participants for incident coronary heart disease or using time-dependent models to account for the use of β-blockers or calcium channel blockers during follow-up did not alter the results.
  
  
  CONCLUSIONS
  Baseline or persistent higher resting heart rate is an independent risk factor for the development of heart failure in healthy older men in the general population.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. david.nanchen@chuv.ch
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.forename: Maarten J G
authors.initials: MJ
authors.lastname: Leening
authors.forename: Isabella
authors.initials: I
authors.lastname: Locatelli
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.forename: Jan A
authors.initials: JA
authors.lastname: Kors
authors.forename: Jan
authors.initials: J
authors.lastname: Heeringa
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Abbas
authors.initials: A
authors.lastname: Dehghan
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors
keywords: cardiovascular disease; heart failure; population-based; resting heart rate