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Association of resting heart rate and hypertension stages on all-cause and cardiovascular mortality among elderly Koreans: the Kangwha Cohort Study

 Mikyung Ryu  ;  Gombojav Bayasgalan  ;  Heejin Kimm  ;  Chung Mo Nam  ;  Heechoul Ohrr 
 JOURNAL OF GERIATRIC CARDIOLOGY, Vol.13(7) : 573-579, 2016 
Journal Title
Issue Date
Cardiovascular diseases ; Heart rate ; Hypertension ; Mortality ; Prehypertension
BACKGROUND: Elevated resting heart rate and hypertension independently increase the risk of mortality. However, their combined effect on mortality in stages of hypertension according to updated clinical guidelines among elderly population is unclear.

METHODS: We followed a cohort of 6100 residents (2600 males and 3500 females) of Kangwha County, Korea, ranging from 55 to 99 year-olds as of March 1985, for all-cause and cardiovascular mortality for 20.8 years until December 31, 2005. Mortality data were collected through telephone calls and visits (to 1991), and were confirmed by death record matching with the National Statistical Office (1992-2005). Hazard ratios were calculated for all-cause and cardiovascular mortality by resting heart rate and hypertension defined by Eighth Joint National Committee criteria using the Cox proportional hazard model after controlling for confounding factors.

RESULTS: The hazard ratios associated with resting heart rate > 80 beats/min were higher in hypertensive men compared with normotensives with heart rate of 61-79 beats/min, with hazard ratios values of 1.43 (95% CI: 1.00-1.92) on all-cause mortality for prehypertension, 3.01 (95% CI: 1.07-8.28) on cardiovascular mortality for prehypertension, and 8.34 (95% CI: 2.52-28.19) for stage 2 hypertension. Increased risk (HR: 3.54, 95% CI: 1.16-9.21) was observed among those with both a resting heart rate ≥ 80 beats/min and prehypertension on cardiovascular mortality in women.

CONCLUSIONS: Individuals with coexisting elevated resting heart rate and hypertension, even in prehypertension, have a greater risk for all-cause and cardiovascular mortality compared to those with elevated resting heart rate or hypertension alone. These findings suggest that elevated resting heart rate should not be regarded as a less serious risk factor in elderly hypertensive patients.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kimm, Heejin(김희진) ORCID logo https://orcid.org/0000-0003-4526-0570
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
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