Heart rate and mortality

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Abstract
Reunanen A, Karjalainen J, Ristola P, Heliövaara M, Knekt P, Aromaa A (National Public Health Institute, Helsinki, Central Military Hospital, Helsinki, and Kvaerner Masa‐Yards Helsinki New Shipyard, Helsinki, Finland). Heart rate and mortality.J Intern Med2000;247: 231–239.Objectives.Increased heart rate has shown to be associated with risk of mortality from cardiovascular diseases in some studies, but not in others. Increased heart rate has also been linked to causes of death other than cardiovascular. To clarify the role of heart rate as a predictor of death we studied its predictive value in a large population study.Design.A prospective population study with a follow‐up time of 23 years.Subjects and methods.The study population comprised 5598 men and 5119 women 30–59 years of age on entry. Heart rate was measured from resting ECGs.Main outcome measure.Mortality from specified causes.Results.A total of 1848 men and 840 women died during the follow‐up period. Increased heart rate was significantly associated with death from all causes, cardiovascular causes, and natural noncardiovascular, nonmalignant causes of death. Increased heart rate was associated with death from cancer in men with heart disease but not in men without heart disease on entry into the study. The increase in cardiovascular mortality with high heart rate was explained by the close association between heart rate and blood pressure. Adjustment for risk factors did not alter the significance of the association between increased heart rate and mortality from noncardiovascular causes.Conclusions.High heart rate is simple to observe clinically and a significant if nonspecific predictor of mortality. Increased risk of mortality from cardiovascular diseases can be explained by association with high blood pressure. The increased mortality risk associated with high heart rate related mainly to a group of diseases of noncardiovascular or nonmalignant origin.