Abstract
Background and aim
Epidemiological studies have reported increased risk of cardiovascular disease, cancer
and all-cause mortality with greater resting heart rate, however, the evidence is
not consistent. Differences by gender, adjustment for confounding factors, as well
as the potential impact of subclinical disease are not clear. A previous meta-analysis
missed a large number of studies, and data for atrial fibrillation have not been summarized
before. We therefore aimed to clarify these associations in a systematic review and
meta-analysis of prospective studies.
Methods and results
PubMed and Embase were searched up to 29 March 2017. Summary RRs and 95% confidence
intervals (CIs) were calculated using random effects models. Eighty seven studies
were included. The summary RR per 10 beats per minute increase in resting heart rate
was 1.07 (95% CI: 1.05–1.10, I2 = 61.9%, n = 31) for coronary heart disease, 1.09 (95% CI: 1.00–1.18, I2 = 62.3%, n = 5) for sudden cardiac death, 1.18 (95% CI: 1.10–1.27, I2 = 74.5%, n = 8) for heart failure, 0.97 (95% CI: 0.92–1.02, I2 = 91.4%, n = 9) for atrial fibrillation, 1.06 (95% CI: 1.02–1.10, I2 = 59.5%, n = 16) for total stroke, 1.15 (95% CI: 1.11–1.18, I2 = 84.3%, n = 35) for cardiovascular disease, 1.14 (95% CI: 1.06–1.23, I2 = 90.2%, n = 12) for total cancer, and 1.17 (95% CI: 1.14–1.19, I2 = 94.0%, n = 48) for all-cause mortality. There was a positive dose–response relationship
for all outcomes except for atrial fibrillation for which there was a J-shaped association.
Conclusion
This meta-analysis found an increased risk of coronary heart disease, sudden cardiac
death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer
and all-cause mortality with greater resting heart rate.
Keywords
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Article info
Publication history
Published online: April 21, 2017
Accepted:
April 13,
2017
Received in revised form:
April 6,
2017
Received:
December 8,
2016
Identification
Copyright
© 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
