Elevations in time-varying resting heart rate predict subsequent all-cause mortality in older adults.
BACKGROUND
An increased resting heart rate (RHR) has long been associated with unhealthy life. Nevertheless, it remains uncertain whether time-varying measurements of RHR are predictive of mortality in older persons.


METHODS
The purpose of this study was to assess the relationship between repeated measurements of RHR and risk of death from all causes among older adults.


METHODS
We evaluated repeat measurements of resting heart rate among 5691 men and women (aged 65 years or older) enrolled in the Cardiovascular Health Study. RHR was measured annually for six consecutive years by validated electrocardiogram. All-cause mortality was confirmed by a study-wide Mortality Review Committee using reviews of obituaries, death certificates and hospital records, interviews with attending physicians, and next-of-kin.


RESULTS
Of the study cohort, 974 (17.1%) participants died. Each 10 beat/min increment in RHR increased the risk of death by 33% (adjusted hazard ratio, 95% confidence interval (CI) = 1.33, 1.26-1.40). Similar results were observed (adjusted hazard ratio, 95% CI = 2.21, 1.88-2.59) when comparing the upper-most quartile of RHR (mean = 81 beats/min) with the lowest (mean = 53 beats/min). Compared with participants whose RHR was consistently ≤65 beats/min during the study period, the risk of death increased monotonically for each 10 beat/min (consistent) increment in RHR, with adjusted hazard ratios (95% CI) ranging from 1.30 (1.23-1.37) for 75 beats/min to 4.78 (3.49-6.52) for 125 beats/min.


CONCLUSIONS
Elevations in the RHR over the course of six years are associated with an increased risk of all-cause mortality among older adults.
Department of Internal Medicine/Geriatrics, Yale School of Medicine, USA briain.ohartaigh@yale.edu.
Bríain ó
Bó
Hartaigh
Department of Internal Medicine/Geriatrics, Yale School of Medicine, USA.
Heather G
HG
Allore
Department of Internal Medicine/Geriatrics, Yale School of Medicine, USA.
Mark
M
Trentalange
Department of Internal Medicine/Geriatrics, Yale School of Medicine, USA.
Gail
G
McAvay
Department of Internal Medicine, Medical University of Graz, Austria.
Stefan
S
Pilz
Department of Internal Medicine, Brigham and Women's Hospital, USA.
John A
JA
Dodson
Department of Internal Medicine/Geriatrics, Yale School of Medicine, USA.
Thomas M
TM
Gill
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D004562:Electrocardiography; D005260:Female; D006304:Health Status; D006339:Heart Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012146:Rest; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
Time-varying; all-cause mortality; older; resting heart rate