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. 2019 May;21(5):589-597.
doi: 10.1111/jch.13529. Epub 2019 Apr 5.

Associations between resting heart rate, hypertension, and stroke: A population-based cross-sectional study

Lihua Hu  1 , Xiao Huang  1 , Wei Zhou  2 , Chunjiao You  1 , Qian Liang  3 , Di Zhou  4 , Juxiang Li  1 , Ping Li  1 , Yanqing Wu  1 , Qinghua Wu  1 , Zengwu Wang  5 , Runlin Gao  6 , Huihui Bao  1 , Xiaoshu Cheng  1
Affiliations

Associations between resting heart rate, hypertension, and stroke: A population-based cross-sectional study

Lihua Hu et al. J Clin Hypertens (Greenwich). 2019 May.

Abstract

Uncertainty remains regarding the association between resting heart rate (RHR) with hypertension and stroke because of limited and inconsistent data. We assessed the association between RHR, hypertension, and stroke. In this cross-sectional study, 14 677 participants from the China Hypertension Survey study were analyzed. The history of stroke was conducted by questionnaires. RHR was measured by the standardized electronic monitors. Multivariate logistic regression analyses were performed to evaluate the association between RHR, hypertension, and stroke. Moreover, a generalized additive model (GAM) and smooth curve fitting (penalized spline method) were conducted to assess the association between RHR and stroke in different status of hypertension. Overall, each 10 beats per minute (bpm) increase in RHR was associated with an 18% increased prevalence of stroke (P = 0.017). Subjects with RHR > 80 bpm were associated with a higher prevalence of stroke (OR = 1.47; 95% CI, 1.08-2.01) compared with those with RHR ≤ 80 bpm. Similarly, hypertensives had a higher prevalence of stroke than normotensives (OR = 3.76; 95% CI, 2.39-5.92). Hypertensives with RHR > 80 bpm had the highest prevalence of stroke compared with their counterparts (OR = 5.47; 95% CI, 3.13-9.56). The fully adjusted smooth curve fitting presented a linear association between RHR and stroke among participants with hypertension, but almost horizontal association among participants without hypertension. In conclusion, elevated RHR and hypertension were independently and jointly associated with the increased prevalence of stroke. These findings suggested that elevated RHR was associated with increased prevalence of stroke especially among hypertensives.

Keywords: China; hypertension; resting heart rate; stroke.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Dose‐response relationship between RHR tertiles and multivariable‐adjusted ORs and 95% confidence intervals of stroke, stratified by hypertension status. Adjustment for sex, age, area, smoking, drinking, education status, occupation, sleep duration (workdays and non‐workdays), antihypertensive medications, family history of cardiac‐cerebral vascular diseases (CHD, stroke, diabetes, hypertension), BMI, WC, SBP, and DBP
Figure 2
Figure 2
Association between RHR and stroke stratified by hypertension status. The smooth curve fitting presented a linear association between RHR and stroke among participants with hypertension, but almost horizontal association among participants without hypertension. Adjustment factors included sex, age, area, smoking, drinking, education status, occupation, sleep duration (workdays and non‐workdays), antihypertensive medications, family history of cardiac‐cerebral vascular diseases (CHD, stroke, diabetes, hypertension), BMI, WC, SBP, and DBP
Figure 3
Figure 3
Effect size of rest heart rate on stroke in each subgroup. Adjusted, if not stratified, for Adjusted for sex, age, area, smoking, drinking, education status, occupation, sleep duration (workdays and non‐workdays), hypertension, antihypertensive medications, family history of cardiac‐cerebral vascular diseases (CHD, stroke, diabetes, hypertension), BMI, WC, SBP, and DBP
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