Floyd James S, Sitlani Colleen M, Wiggins Kerri L, Wallace Erin, Suchy-Dicey Astrid, Abbasi Siddique A, Carnethon Mercedes R, Siscovick David S, Sotoodehnia Nona, Heckbert Susan R, McKnight Barbara, Rice Kenneth M, Psaty Bruce M
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA Department of Medicine, University of Washington, Seattle, Washington, USA.
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
Heart. 2015 Jan;101(2):132-8. doi: 10.1136/heartjnl-2014-306046. Epub 2014 Sep 11.
Resting heart rate (RHR) is an established predictor of myocardial infarction (MI) and mortality, but the relationship between variation in RHR over a period of several years and health outcomes is unclear. We evaluated the relationship between long-term variation in RHR and the risks of incident MI and mortality among older adults.
1991 subjects without cardiovascular disease from the Cardiovascular Health Study were included. RHR was taken from resting ECGs at the first five annual study visits. RHR mean, trend and variation were estimated with linear regression. Subjects were followed for incident MI and death until December 2010. HRs for RHR mean, trend and variation are reported for differences of 10 bpm, 2 bpm/year and 2 bpm, respectively.
262 subjects had an incident MI event (13%) and 1326 died (67%) during 12 years of median follow-up. In primary analyses adjusted for cardiovascular risk factors, RHR mean (HR 1.12; 95% CI 1.05 to 1.20) and variation (HR 1.08; 95% CI 1.03 to 1.13) were associated with the risk of death while trend was not. None of the RHR variables were significantly associated with the risk of incident MI events; however, CIs were wide and the MI associations with RHR variables were not significantly different from the mortality associations. Adjusting for additional variables did not affect estimates, and there were no significant interactions with sex.
Variation in RHR over a period of several years represents a potential predictor of long-term mortality among older persons free of cardiovascular disease.
静息心率（RHR）是心肌梗死（MI）和死亡率的既定预测指标，但数年间RHR的变化与健康结局之间的关系尚不清楚。我们评估了老年人RHR的长期变化与新发MI风险和死亡率之间的关系。
纳入心血管健康研究中1991名无心血管疾病的受试者。在前五次年度研究访视时，通过静息心电图获取RHR。采用线性回归估计RHR均值、趋势和变化。对受试者进行随访，观察新发MI和死亡情况，直至2010年12月。分别报告RHR均值、趋势和变化每相差10次/分钟、2次/分钟/年和2次/分钟时的风险比（HR）。
在12年的中位随访期内，262名受试者发生了新发MI事件（13%），1326人死亡（67%）。在针对心血管危险因素进行校正的初步分析中，RHR均值（HR 1.12；95%置信区间[CI] 1.05至1.20）和变化（HR 1.08；95% CI 1.03至1.13）与死亡风险相关，而趋势则不然。没有一个RHR变量与新发MI事件风险显著相关；然而，置信区间较宽，且MI与RHR变量之间的关联与死亡率关联无显著差异。调整其他变量并未影响估计值，且与性别无显著交互作用。
数年间RHR的变化是无心血管疾病老年人长期死亡率的一个潜在预测指标。
