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High heart rate is risk factor for death, not just a sign of poor fitness, study indicates

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2429 (Published 16 April 2013) Cite this as: BMJ 2013;346:f2429

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Re: High heart rate is risk factor for death, not just a sign of poor fitness, study indicates

Clinicians must have intuitively doubted the report “… found that a resting heart rate in 1985-6 of between 51 and 60 bpm was associated with a 40% increase in death…. when compared with a rate under 50.” The abstract of the original paper states ,“With RHR as a continuous variable, risk of mortality increased with 16% (10–22) per 10 beats per minute (bpm).”

I have often wondered if the original data on the significance of systolic hypertension in relation to cardiovascular outcomes have ever been re-worked, adjusting for resting heart rate. If cardiac output is the product of heart rate and stroke volume, then a slower heart must mean a higher stroke volume, which should equate to a wider pulse pressure.

I must admit to a personal interest as a fit 73 year old with a lifetime RHR of 48-50 bpm, systolic BP 150-165 and diastolic BP of 70-80.

Competing interests: No competing interests

23 April 2013
John Dickinson
Retired physician
Leeds University Medical School
Richmond, N Yorks DL10