title: Bradycardia is associated with future cardiovascular diseases and death in men from the general population.
abstract: BACKGROUND
  Although a higher heart rate is known to be a risk factor for cardiovascular disease (CVD) events, there have been no reports concerning bradycardia. Whether lower and higher resting pulse rates (RPRs) are associated with cardiovascular risk was investigated in subjects from a community-based, prospective cohort study.
  
  
  METHODS
  After subjects with atrial fibrillation, subjects with a history of CVD, and subjects receiving antihypertensive treatment were excluded, 17,766 subjects (5958 men), aged 40-79 (mean 61.5) years, were analyzed. The RPR at baseline was categorized into four groups (RPR<60, 60-69.5, 70-79.5, ≥80 beats per minute (bpm)) using the average value of two consecutive measurements. The endpoint was set as the composite outcome of myocardial infarction, stroke, or sudden death.
  
  
  RESULTS
  During a mean follow-up of 5.6 years, there were 213 events in men and 186 events in women. In Cox regression models, increased risks of CVD were found in the men group with RPR<60 bpm, as well as the group with RPR≥80 bpm, compared with the reference group with RPR 60-69.5 bpm (hazard ratio [HR] = 1.73, p = 0.005 and HR = 2.01, p < 0.001). These increased risks were found even when adjusted for age and other CVD risk factors (HR = 1.55, p = 0.026 with RPR<60 bpm and HR = 1.72, p = 0.009 with RPR≥80 bpm). In women, there were no significant associations between RPR and CVD risk.
  
  
  CONCLUSIONS
  Bradycardia, as well as a higher pulse rate, may be an independent risk factor for future cardiovascular events in apparently healthy men.
authors.affiliation: Division of Cardioangiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. Electronic address: makitas@seagreen.ocn.ne.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Makita
authors.affiliation: Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Onoda
authors.affiliation: Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohsawa
authors.affiliation: Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Tanno
authors.affiliation: Division of Cardioangiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Omama
authors.affiliation: Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Department of Neurology, Iwate Medical University, Morioka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ishibashi
authors.affiliation: Department of Nutritional Sciences, Morioka University, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Itai
authors.affiliation: Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Iwate Health Service Association, Morioka, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Ohta
authors.affiliation: Department of Health and Physical Education, Faculty of Education, Iwate University, Morioka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kuribayashi
authors.affiliation: Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.affiliation: Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
authors.affiliation: First Institute of Health Service, Japan Anti-Tuberculosis Association, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.affiliation: Division of Cardioangiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D001919:Bradycardia / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000401:mortality*; D003645:Death, Sudden; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012737:Sex Factors; D020521:Stroke / Q000401:mortality
keywords: Acute myocardial infarction; Bradycardia; Epidemiology; Pulse rate; Stroke