Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study

doi:10.1136/bmj.b219

Published 3 February 2009, doi:10.1136/bmj.b219
Cite this as: BMJ 2009;338:b219

Research

Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study

Judith Hsia, professor ¹, Joseph C Larson, statistician ², Judith K Ockene, professor³, Gloria E Sarto, professor⁴, Matthew A Allison, assistant professor⁵, Susan L Hendrix, physician⁶, Jennifer G Robinson, associate professor⁷, Andrea Z LaCroix, professor², JoAnn E Manson, professor⁸, for the Women’s Health Initiative Research Group

¹ George Washington University, Washington, DC 20037 , ² Fred Hutchinson Cancer Research Center, Seattle, WA 98109, ³ University of Massachusetts, Worcester, MA 01655 , ⁴ University of Wisconsin, Madison, WI 53715 , ⁵ University of California San Diego, La Jolla, CA 92093 , ⁶ Detroit Medical Center, Detroit, MI 48201 , ⁷ University of Iowa, Iowa City, IA 52242 , ⁸ Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215

Correspondence to: J Hsia, AstraZeneca LP, Wilmington, DE 19850 judith.hsia{at}astrazeneca.com

Objective To evaluate resting heart rate as an independent predictorof cardiovascular risk in women.

Design Prospective cohort study.

Setting The Women’s Health Initiative was undertaken at40 research clinics in the United States.

Participants 129 135 postmenopausal women.

Main outcome measure Clinical cardiovascular events.

Results During a mean of 7.8 (SD 1.6) years of follow up, 2281women were identified with myocardial infarction or coronarydeath and 1877 with stroke. We evaluated associations betweenresting heart rate and cardiovascular events in Cox regressionmodels adjusted for multiple covariates. Higher resting heartrate was independently associated with coronary events (hazardratio 1.26, 95% confidence interval 1.11 to 1.42 for highest[>76 beats per minute] v lowest quintile [ $≤$ 62 beats per minute];P=0.001), but not with stroke. The relation between heart rateand coronary events did not differ between white women and womenfrom other ethnic groups (P for interaction=0.45) or betweenwomen with and without diabetes (P for interaction=0.31), butit was stronger in women aged 50-64 at baseline than in thoseaged 65-79 (P for interaction=0.009).

Conclusion Resting heart rate, a low tech and inexpensive measureof autonomic tone, independently predicts myocardial infarctionor coronary death, but not stroke, in women.

Trial registration ClinicalTrials.gov NCT00000611 [ClinicalTrials.gov] .

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