Department of Preventive Medicine and Public Health, Keio University School of Medicine.
Faculty of Nursing and Medical Care, Keio University.
J Epidemiol. 2023 May 5;33(5):227-235. doi: 10.2188/jea.JE20210114. Epub 2022 Feb 11.
Elevated resting heart rate (RHR) is associated with an increased risk of cardiovascular disease (CVD) and all-cause mortality. However, the findings of cohort studies differed. Thus, the impact of RHR on CVD mortality might be different according to the background of the population. Therefore, we examined the relationship of RHR and CVD mortality according to serum albumin (ALB) levels in a Japanese general population.
In total, 8,363 individuals without a history of CVD were followed for 24.0 years. The participants were divided into four groups according to the quartiles of RHR (Q1-Q4), and they were further classified into the high and low ALB groups based on a median value of 44 g/L. We estimated the multivariable-adjusted hazard ratios (HRs) of CVD mortality in each RHR group based on ALB levels, and the interaction between RHR and ALB groups on CVD mortality was evaluated.
We found no significant association between RHR and CVD mortality. However, the Q4 of RHR was significantly associated with an increased risk for CVD mortality (HR 1.27; 95% confidence interval [CI], 1.02-1.57) in participants with a low ALB level. Meanwhile, the Q4 of RHR was significantly correlated with a decreased risk for CVD morality in those with a high ALB level (HR 0.61; 95% CI, 0.47-0.79) after adjusting for covariates. A significant interaction between RHR and ALB for CVD mortality was shown (P < 0.001).
The impact of RHR on CVD mortality differed according to ALB levels in a general Japanese population.
静息心率(RHR)升高与心血管疾病(CVD)和全因死亡率增加相关。然而,队列研究的结果存在差异。因此,RHR 对 CVD 死亡率的影响可能因人群背景而异。因此,我们在日本一般人群中,根据血清白蛋白(ALB)水平研究了 RHR 与 CVD 死亡率的关系。
共有 8363 名无 CVD 病史的个体随访 24.0 年。根据 RHR(Q1-Q4)的四分位间距将参与者分为四组,并根据 44g/L 的中位数将他们进一步分为高和低 ALB 组。我们根据 ALB 水平估计了每个 RHR 组 CVD 死亡率的多变量校正风险比(HR),并评估了 RHR 和 ALB 组之间对 CVD 死亡率的交互作用。
我们没有发现 RHR 与 CVD 死亡率之间存在显著关联。然而,低 ALB 水平的参与者中,RHR 的 Q4 与 CVD 死亡率增加显著相关(HR 1.27;95%置信区间[CI],1.02-1.57)。同时,在调整了协变量后,高 ALB 水平的参与者中,RHR 的 Q4 与 CVD 死亡率降低显著相关(HR 0.61;95%CI,0.47-0.79)。RHR 和 ALB 对 CVD 死亡率的交互作用具有统计学意义(P<0.001)。
在日本一般人群中,RHR 对 CVD 死亡率的影响因 ALB 水平而异。