Li Kuibao, Yao Chonghua, Yang Xinchun, Dong Lei
Heart Center of Beijing, Chaoyang Hospital, Capital Medical University, Beijing, China.
Beijing Centers for Disease Control and Prevention, Anzhen Hospital, Capital Medical University, Beijing, China.
J Am Geriatr Soc. 2017 May;65(5):989-994. doi: 10.1111/jgs.14714. Epub 2016 Dec 30.
To examine whether the association between resting heart rate (RHR) and all-cause mortality and cardiovascular events differs according to age.
Prospective cohort.
Community in Beijing, China.
Individuals aged 40 and older without cardiovascular disease at baseline (N = 6,209).
Trained investigators interviewed participants using a standard questionnaire to obtain information on demographic characteristics, medical history and lifestyle risk factors in 1991. RHR was evaluated according to quartiles (<72, 72-76, 76-84, ≥84 beats/min). Cox regression models were used to assess the associations between RHR and all-cause mortality and cardiovascular events.
During a mean follow-up of 8.3 years, 840 subjects died, and 676 experienced a cardiovascular event. Higher RHR was significantly associated with all-cause mortality (P trend < .001) and cardiovascular events (P trend = .002) in older (≥60) but not younger (<60) participants (both P trend > .05). There were significant modifying effects of age on the association between RHR and all-cause mortality (P interaction < .001) and cardiovascular events (P interaction =.002). Similar results were observed after exclusion of individuals who died (n = 100) or had a cardiovascular event (n = 45) during the first 2 years of follow-up.
High RHR appears to be an independent determinant of all-cause mortality and cardiovascular events in older but not younger individuals.
探讨静息心率（RHR）与全因死亡率及心血管事件之间的关联是否因年龄而异。
前瞻性队列研究。
中国北京的社区。
基线时年龄在40岁及以上且无心血管疾病的个体（N = 6209）。
1991年，经过培训的调查人员使用标准问卷对参与者进行访谈，以获取有关人口统计学特征、病史和生活方式风险因素的信息。根据四分位数（<72、72 - 76、76 - 84、≥84次/分钟）评估RHR。使用Cox回归模型评估RHR与全因死亡率及心血管事件之间的关联。
在平均8.3年的随访期间，840名受试者死亡，676名发生了心血管事件。在年龄较大（≥60岁）的参与者中，较高的RHR与全因死亡率（P趋势<.001）和心血管事件（P趋势 =.002）显著相关，但在年龄较小（<60岁）的参与者中则不然（两者P趋势>.05）。年龄对RHR与全因死亡率（P交互作用<.001）和心血管事件（P交互作用 =.002）之间的关联有显著的修正作用。在排除随访前两年内死亡（n = 100）或发生心血管事件（n = 45）的个体后，观察到了类似的结果。
高RHR似乎是老年个体而非年轻个体全因死亡率和心血管事件的独立决定因素。
