P5311Resting high heart rate among Russian men and women and its association with cause-specific mortality
Authors: Shalnova S , Kapustina A , Deev A , Balanova Y , Imaeva A , Muromtseva G 
Published: October 2019

Abstract

Introduction
It is well known that high heart rate (HHR) is the independent risk factor for all cause and CVD mortality. Less known about HHR associations with various cause-relative deaths.

Purpose
to evaluate the impact of HHR in cause-specific mortality among Russian men and women.

Methods
The data were obtained from seven independent cross-sectional population surveys, conducted in 1975–2001 in Moscow and St Petersburg (Leningrad) in which a randomly selected population aged 35–74 years was studied at different periods of time. The total number of respondents was 20 045 (15107 men and 4938 women). The surveys were carried out using the single core protocol with the standard methods and criteria. Socio-demographic characteristics, smoking status, alcohol intake, body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), lipid levels [total cholesterol (TC), high density lipoproteins-cholesterol (HDL-C), triglycerides (TG)] and resting electrocardiogram (ECG) were measured. CHD status was defined as: angina pectoris (AP) assessed by Rose questionnaire and/or ECG disturbances by Minnesota code: Q-QS waves (Major QQS: 111–127; Minor QQS: 128, 13), ST-T ischemia (major ischemia: 41,2 an/or 51,2 without 31,33; Ischemia minor: 43,53). Heart rate was measurement on ECG record. HHR was defined as >80 beat/min. Follow-up period was more than 23.5 years. Hazard ratios (HR) and 95% confidence intervals (CI) for estimation the associations between HHR and cause specific mortality were evaluated by Cox regression, with adjustment for risk variables such as age, smoking status, alcohol consumption, blood pressure level, lipids disturbance and CHD.

Results
During the follow-up period 10648 deaths (8724 in men and 1924 in women) occurred. The other mortality events consisted of 3495 CHD deaths, 1641 stroke deaths, 5680 CVD and 4287 non CVD deaths for both sexes. Mean age of the sample was 46.5±0.01 b/min. After adjustment for age, risk factors, CHD status and education, the association between HHR and all-cause mortality was 1.25 ([1.16–1.34], p=0,0001) among men; 1.21 ([1.04–1.86], p=0.0102) – among women. For CVD deaths - 1.23 ([1.12–1.36], p=0.0001) and 1.19 ([0.97–1.45], p=0.0902) – among men and women, respectively. HHR was also associated with non-CVD mortality among men but not in women: 1.38 ([1.18–1.62], p=0.0001) and 1.28 ([0.93–1.77], p=0.1345), respectively. The same was found for stroke mortality: for men – 1.45 ([1.06–1.98], p=0,0183), for women - 1.28 ([0.93–1.77], p=1345). The HHR was associated with CHD mortality only in men in women this indicator was not even selected for model.

Conclusions
HHR is the independent risk factor for every cause-specific mortality even after adjustment for age, risk factors profile and CHD history among Russian men while among women the positive association was found only for all-cause mortality. Probably HHR can be considered at least in men as a marker of general health.