Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study.

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Abstract
BACKGROUND: Prospective epidemiological studies indicate that elevated heart rate may carry increased risk for coronary heart disease. Little is known about the relation between heart rate and serum lipid and lipoprotein concentrations in the general population. METHODS AND RESULTS: We assessed anthropometric and life-style determinants of heart rate and examined the association between heart rate and serum lipid and lipoprotein concentrations in a cross-sectional study of 9,719 men and 9,433 women 12-59 years old. Stratified and multivariate analyses were used to detect possible modification of effect and to control for confounding variables. Heart rate was positively associated with male sex and smoking, decreased with body height and physical activity, and showed a U-shaped relation to body mass index. In both sexes, there was a significant progressive increase in age-adjusted levels of total cholesterol, non-high density lipoprotein (HDL) cholesterol, and triglycerides and a decrease in HDL cholesterol with heart rate. Men with heart rate greater than 89 beats per minute had 14.5% higher non-HDL cholesterol and 36.3% higher triglyceride levels than men with heart rate less than 60 beats per minute. The corresponding differences in women were 12.5% and 22.2%. The associations remained significant when anthropometric and life-style factors were controlled for. The slopes relating total and non-HDL cholesterol level to heart rate were steeper with advancing age. CONCLUSIONS: Increases in heart rate correlate with higher levels of atherogenic serum lipid fractions in the general population. Alterations in aortic impedance and/or autonomic influences may underlie these associations.