Li Yuechun
Department of Cardiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai, China.
Int J Clin Exp Med. 2015 Sep 15;8(9):15329-39. eCollection 2015.
The results from published studies on resting heart rate (RHR) and risk of cardiovascular mortality are not consistent. We therefore conducted a meta-analysis to quantitatively summarize the evidence from prospective studies about the association of RHR with risk cardiovascular mortality. Pertinent studies were identified by a search of Pubmed and Web of Knowledge to January 2015. The random effect model was used. Sensitivity analysis and publication bias were conducted. Dose-response relationship was assessed by restricted cubic spline and variance-weighted least squares regression analysis. Twenty prospective articles were included in this meta-analysis. Pooled results suggested that highest RHR level versus lowest levels was significantly associated with the risk of cardiovascular mortality [summary relative risk (RR) = 1.69, 95% CI = 1.42-2.00, I(2) = 87.5%]. Subjects with RHR levels of > 80 bites per minute (bpm) had a RR of 1.49 (1.24-1.79) for cardiovascular mortality. The results for subgroups analysis of geographic locations, sex and duration of follow-up are consistent with the overall results. The linear dose-response analysis indicated that an increase in RHR of 10 bpm was statistically significantly associated with a 6% increase in the risk of developing cardiovascular mortality (summary RR = 1.06, 95% CI = 1.04-1.08). Thus, we conclude that elevated RHR was significantly associated with an increased risk of cardiovascular mortality.
已发表的关于静息心率（RHR）与心血管疾病死亡风险的研究结果并不一致。因此，我们进行了一项荟萃分析，以定量总结前瞻性研究中有关RHR与心血管疾病死亡风险之间关联的证据。通过检索截至2015年1月的PubMed和Web of Knowledge来确定相关研究。采用随机效应模型。进行了敏感性分析和发表偏倚分析。通过限制性立方样条和方差加权最小二乘回归分析评估剂量反应关系。本荟萃分析纳入了20篇前瞻性文章。汇总结果表明，最高RHR水平与最低水平相比，与心血管疾病死亡风险显著相关[汇总相对风险（RR）=1.69，95%置信区间（CI）=1.42 - 2.00，I² = 87.5%]。静息心率水平>80次/分钟（bpm）的受试者心血管疾病死亡的RR为1.49（1.24 - 1.79）。地理位置、性别和随访时间亚组分析的结果与总体结果一致。线性剂量反应分析表明，静息心率每增加10 bpm，心血管疾病死亡风险增加6%在统计学上具有显著相关性（汇总RR = 1.06，95% CI = 1.04 - 1.08）。因此，我们得出结论，静息心率升高与心血管疾病死亡风险增加显著相关。
