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Resting heart rate 'predicts mortality'

A rising resting heart rate may be an ‘important prognostic marker' for all-cause death and heart disease, say researchers.

In a large observational study, researchers from Norway measured the resting heart rate of 29,300 patients without known cardiovascular disease. The rate was measured on two occasions around ten years apart and patients were followed up for an average of 12 years.

Over the course of the study there were 3,038 deaths, including 388 from ischaemic heart disease.

Participants whose resting heart rate was less than 70 beats per minute at the first measurement but greater than 85bpm at the second measurement had a 90% increased risk of death from  ischaemic heart disease compared with those whose heart rates  remained stable at less than 70.

Those whose rate was between 70 and 85bpm at the first measurement and greater than 85bpm at the second had an 80% increased risk of death from ischaemic heart disease.

An association was found for all causes of mortality, but it was weaker than with ischaemic heart disease mortality. Also, a decrease in resting heart rate showed no benefit in terms of ischaemic heart disease mortality.

The researchers controlled for potential confounding factors: ‘It is likely that a temporal reduction in resting heart rate will reflect good underlying health, and could therefore be a marker of a healthy lifestyle, including engagement in physical activity and low prevalence of smoking.'

Lead author Dr Javaid Nauman, research fellow at the Norwegian University of Science and Technology, said:  ‘Our findings provide further support for the hypothesis that resting heart rate may be an important prognostic marker for ischemic heart disease and total mortality.'

‘Information on resting heart rate and its time-related changes are easy to obtain and follow up and may be useful in identifying asymptomatic people who could benefit from measures of primary prevention.'

JAMA 2011; 306: 2579-2587

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