Elevated Resting Heart Rate Linked to Increased Cardiac Risk in Postmenopausal Women
05 feb 2009--Resting heart rate : a "low tech and inexpensive measure of autonomic tone" — independently predicts coronary risk in postmenopausal women, according to an analysis from the Women's Health Initiative published online in BMJ.
Researchers measured resting heart rate among nearly 130,000 postmenopausal women without histories of MI, stroke, or coronary revascularization. During 8 years' follow-up, 2300 coronary events (MI or coronary death) and 1900 strokes occurred.
After adjustment for confounders including age, smoking, hormone use, and physical activity, coronary risk was 26% higher among women with the highest resting heart rates (greater than 76 beats/minute) than among those with the lowest (62 beats/minute or less). Resting heart rate did not predict stroke risk.
The authors conclude that the association between resting heart rate and coronary risk "might be large enough to be clinically meaningful."
LINK(S):
BMJ article (Free)
1 comment:
The researchers clearly highlight the strengths and limitations of their study, these include the following:
* This is a large cohort study including a diverse group of women and measuring a large number of adverse events. The size of the sample means the study has high power to detect differences between women with different pulse rates.
* The study also collected a lot of information on other factors that can affect heart risk. This is a strength of the study because researchers were able to adjust for the effects of these additional factors on coronary risk.
* One limitation is that the cohort does not include men, or women younger than 50 years.
This result is important as it supports the use of resting heart rate as a predictor of heart problems in women. Previous research has established this in men. The researchers acknowledge that the link is weaker than that with cigarette smoking or diabetes, but is still clinically meaningful.
Whether or how these results will change clinical practice is not clear. Although a high resting pulse rate may indicate the risk of a future coronary event, any such interpretation should always take into account the individual’s circumstances, such as the presence of other coronary risk factors and the many other reasons for a raised pulse, such as current illness or anxiety. Pulse rate can vary due to a number of reasons, and several readings should ideally be taken to confirm the normal resting rate for the person. A useful addition to this study would have been to assess pulse rate during exercise as well as at rest.
Finally, this study found that people who took regular exercise had lower resting pulse rates, and that people who ate diets with a high saturated fat content had a higher resting pulse. Advice to take from this is to eat a healthy diet and take regular exercise to lower your risk of heart disease. This has been well established in previous studies.
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