Impact of resting heart rate and predicted cardiovascular risk on mortality in nearly 110,000 Chinese adults

Shen, A; Liu, F; Chen, S; Huang, K; Cao, J; Shen, C; Liu, X; Yu, L; Gu, S; Zhao, L; Li, Y; Hu, D; Huang, J; Lu, X; Gu, D; Li, J

doi:10.1016/j.hrthm.2025.03.1990

Prevention & lipids

Impact of resting heart rate and predicted cardiovascular risk on mortality in nearly 110,000 Chinese adults

Heart RhythmPublished 31 Mar 2025Cohort study

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Authors' conclusion

Our findings demonstrated that RHR and CVD risk are independently associated with mortality, and integrating them potentially could refine risk stratification of mortality. The study highlighted their important role in personalized strategies for primordial and primary prevention.

Study context

Population: Chinese adults followed during 1992 to 2015Chinese adults followed up
Participants: 108,257 adults

Exposure: Mortality associated with resting heart rate (RHR) and the predicted risk of incident cardiovascular disease (CVD)
Outcome: Deaths
Follow-up: Average of 8.53 years

Main finding

As reported in the abstract

Nonaccidental deaths

6267

CVD deaths (of the nonaccidental deaths)

2324

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk ←→ Higher risk →	HR (95% CI)
Nonaccidental, CVD and non-CVD mortality by RHRHigh-RHRvs low-RHRNonaccidental mortality	0.20.5125	1.58 (1.47–1.70)
Nonaccidental, CVD and non-CVD mortality by RHRHigh-RHRvs low-RHRCVD mortality	0.20.5125	1.71 (1.53–1.92)
Nonaccidental, CVD and non-CVD mortality by RHRHigh-RHRvs low-RHRnon-CVD mortality	0.20.5125	1.50 (1.37–1.64)
Nonaccidental and CVD mortality by predicted CVD riskHigh CVD riskvs low CVD riskNonaccidental mortality	0.20.5125	1.67 (1.51–1.83)
Nonaccidental and CVD mortality by predicted CVD riskHigh CVD riskvs low CVD riskCVD mortality	0.20.5125	3.90 (3.29–4.61)
	0.20.5125Hazard ratio (log scale)

Nonaccidental and CVD mortality by combined CVD risk and RHR

Nonaccidental mortality HR, both high CVD risk and high RHR: 2.57 (95% CI 2.24-2.94)
CVD mortality HR, both high CVD risk and high RHR: 7.16 (95% CI 5.52-9.29)
Mortality risk gradually increased with elevation of CVD risk and RHR

Comparator for combined HRs not stated in the abstract

Original publication

Impact of resting heart rate and predicted cardiovascular risk on mortality in nearly 110,000 Chinese adults. Heart Rhythm. Published 31 March 2025. doi:10.1016/j.hrthm.2025.03.1990

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