Background
Methods
Cohort selection
Exposure
Outcomes
Covariates
Statistical analysis
Results
Characteristics | Overall | 1st Pulse Rate Decile | 5th Pulse Rate Decile | 10th Pulse Rate Decile | p-value |
---|---|---|---|---|---|
N = 51,194 | (47–59 bpm) | (72–75 bpm) | (97–117 bpm) | ||
n = 7026 | n = 5479 | n = 2929 | |||
Age, y | 66.9 ± 11.5 | 69.4 ± 11 | 11.4 ± 62.5 | 62.5 ± 10.9 | <.0001 |
Sex (male), % | 50,267 (98.2%) | 6949 (98.9%) | 5378 (98.2%) | 2841 (97.0%) | <.0001 |
Race,% | |||||
White | 35,577 (76.9%) | 5061 (79.7%) | 3782 (76.4%) | 1833 (68.5%) | <.0001 |
African American | 9784 (21.1%) | 1170 (18.4%) | 1062 (21.5%) | 798 (29.8%) | |
Other | 912 (2.0%) | 122 (1.9%) | 106 (2.1%) | 46 (1.7%) | |
BMI,% | |||||
< 18.5, kg/m2 | 1225 (2.4%) | 131 (1.9%) | 123 (2.3%) | 137 (4.8%) | <.0001 |
18.5–24.9, kg/m2 | 12,766 (25.7%) | 1959 (28.6%) | 1360 (25.5%) | 807 (28.2%) | |
25–29.9, kg/m2 | 16,551 (33.3%) | 2413 (35.2%) | 1717 (32.2%) | 816 (28.5%) | |
30–34.9, kg/m2 | 10,998 (22.1%) | 1425 (20.8%) | 1221 (22.9%) | 580 (20.3%) | |
≥ 35, kg/m2 | 8203 (16.5%) | 929 (13.6%) | 915 (17.2%) | 520 (18.2%) | |
Baseline EF, % | 26.6 ± 7.4 | 26.9 ± 7.4 | 26.6 ± 7.3 | 25.8 ± 7.5 | <.0001 |
Serum Potassium, mEq/L | 4.3 ± 0.5 | 4.4 ± 0.5 | 4.3 ± 0.5 | 4.3 ± 0.5 | <.0001 |
Serum Sodium, mmol/L | 138.9 ± 3.2 | 139.2 ± 2.9 | 138.9 ± 3.1 | 138.2 ± 3.3 | <.0001 |
eGFR, mL/min/1.73 m2 | 67.7 ± 24.1 | 63.7 ± 22.9 | 67.5 ± 24 | 74.9 ± 25.6 | <.0001 |
Anemia, % | 24,707 (48.3%) | 3591 (51.1%) | 2693 (49.2%) | 1591 (54.3%) | 0.0001 |
Coronary artery disease, % | 37,147 (72.6%) | 5484 (78.1%) | 4097 (74.8%) | 1820 (62.1%) | <.0001 |
Chronic obstructive pulmonary disease, % | 17,902 (35.0%) | 2286 (32.5%) | 1926 (35.2%) | 1409 (48.1%) | <.0001 |
Dementia, % | 5944 (11.6%) | 865 (12.3%) | 625 (11.4%) | 493 (16.8%) | <.0001 |
Diabetes, % | 25,011 (48.9%) | 3155 (44.9%) | 2839 (51.8%) | 1596 (54.5%) | <.0001 |
Hypertension, % | 42,866 (83.7%) | 6155 (87.6%) | 4671 (85.3%) | 2483 (84.8%) | <.0001 |
Peripheral vascular disease, % | 13,091 (25.6%) | 1981 (28.2%) | 1423 (26.0%) | 760 (26.0%) | 0.0025 |
Stroke/Transient ischemic attack, % | 9494 (18.6%) | 1547 (22.0%) | 1025 (18.7%) | 512 (17.5%) | <.0001 |
Hyperlipidemia, % | 38,370 (75.0%) | 5577 (79.4%) | 4229 (77.2%) | 2006 (68.5%) | <.0001 |
Atrial fibrillation/flutter, % | 2673 (5.2%) | 464 (6.6%) | 301 (5.5%) | 188 (6.4%) | <.0001 |
Interval 1 (First 6 months) | Interval 3 (1–1.5 years) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Characteristics | Overall | 1st Pulse Rate Decile | 5th Pulse Rate Decile | 10th Pulse Rate Decile | p-value | Overall | 1st Pulse Rate Decile | 5th Pulse Rate Decile | 10th Pulse Rate Decile | p-value |
N = 44,093 | (47–59 bpm) | (72–75 bpm) | (97–117 bpm) | N = 44,093 | (47–59 bpm) | (72–75 bpm) | (97–117 bpm) | |||
n = 6116 | n = 4753 | n = 2269 | n = 6433 | n = 5094 | n = 2214 | |||||
ACE Inhibitor or ARB, % | 31,716 (77.2%) | 4808 (78.6%) | 3626 (76.3%) | 1741 (76.7%) | 0.0007 | 28,970 (67.0%) | 4523 (70.3%) | 3433 (67.4%) | 1349 (60.9%) | <.0001 |
Aldosterone Antagonists, % | 6574 (16.0%) | 878 (14.4%) | 789 (16.6%) | 410 (18.1%) | <.0001 | 6374 (14.8%) | 838 (13.0%) | 778 (15.3%) | 308 (13.9%) | <.0001 |
Beta blocker, % | 33,407 (81.3%) | 5177 (84.6%) | 3861 (81.20%) | 1696 (74.7%) | <.0001 | 31,735 (73.4%) | 5031 (78.2%) | 3804 (74.7%) | 1373 (62.0%) | <.0001 |
Calcium channel blocker, % | 8626 (21.0%) | 1536 (25.1%) | 945 (19.9%) | 404 (17.8%) | <.0001 | 7861 (18.2%) | 1442 (22.4%) | 890 (17.5%) | 353 (15.9%) | <.0001 |
Statins, % | 29,996 (73.00%) | 4644 (75.9%) | 3488 (723.4%) | 1480 (65.2%) | <.0001 | 28,950 (67.0%) | 4579 (71.2%) | 3401 (66.8%) | 1253 (56.6%) | <.0001 |
Nitrates, % | 8435 (20.5%) | 1426 (23.3%) | 1935 (19.7%) | 397 (17.5%) | <.0001 | 7164 (16.6%) | 1221 (19.0%) | 830 (16.3%) | 274 (12.4%) | <.0001 |
Loop Diuretic, % | 20,508 (49.9%) | 2847 (48.25%) | 2394 (50.4%) | 1287 (56.7%) | <.0001 | 18,575 (43.0%) | 2642 (41.1%) | 2243 (44.0%) | 962 (43.5%) | 0.0084 |
Thiazides, % | 5838 (14.2%) | 939 (15.4%) | 666 (14.0%) | 323 (14.2%) | 0.1137 | 4670 (10.8%) | 785 (12.2%) | 540 (10.6%) | 2055 (9.3%) | 0.005 |
Anticoagulant, % | 4017 (9.8%) | 639 (10.4%) | 456 (9.6%) | 241 (10.6%) | 0.1794 | 3715 (8.6%) | 644 (10.0%) | 407 (8.0%) | 189 (8.5%) | <.0001 |
Digoxin, % | 4410 (10.7%) | 598 (9.8%) | 518 (10.9%) | 287 (12.6%) | 0.0105 | 4176 (9.7%) | 507 (7.9%) | 511 (10.0%) | 234 (10.6%) | <.0001 |
Associations of baseline pulse rate with outcomes
Pulse rate (bpm) | Baseline Crude HR or RRa (95% CI) | Baseline Multivariablec HR or RRa (95% CI) | Longitudinal Crude HR or RRb (95% CI) | Longitudinal Multivariablec HR or RRb (95% CI) | |
---|---|---|---|---|---|
All-Cause Mortality (HR) | 47–59 | 0.91 (0.84–0.98) § | 0.85 (0.76–0.94) § | 0.92 (0.86–0.98) § | 0.84 (0.78–0.90) || |
60–63 | 0.95 (0.88–1.02) | 0.90 (0.81–1.00) | 0.93 (0.87–0.99) § | 0.86 (0.80–0.94) § | |
64–67 | 0.99 (0.92–1.07) | 0.92 (0.83–1.02) | 0.92 (0.86–0.98) § | 0.88 (0.81–0.95) § | |
68–71 | 0.99 (0.92–1.07) | 1.01 (0.92–1.12) | 0.96 (0.90–1.02) | 0.90 (0.83–0.97) § | |
72–75 | – | – | – | – | |
76–79 | 1.10 (1.02–1.18) § | 1.11 (1.01–1.22) § | 1.07 (0.99–1.14) | 1.09 (1.00–1.18) | |
80–83 | 1.07 (1.00–1.16) | 1.14 (1.04–1.27) § | 1.10 (1.02–1.18) § | 1.11 (1.02–1.21) § | |
84–88 | 1.06 (0.99–1.15) | 1.15 (1.04–1.27) § | 1.19 (1.11–1.28) || | 1.22 (1.12–1.33) || | |
89–96 | 1.13 (1.05–1.22) § | 1.25 (1.14–1.38) || | 1.41 (1.32–1.52) || | 1.55 (1.42–1.68) || | |
97–117 | 1.21 (1.12–1.30) || | 1.43 (1.30–1.58) || | 1.84 (1.71–1.97) || | 2.03 (1.86–2.21) || | |
All-Cause Hospitalizations (RR) | 47–59 | 0.79 (0.70–0.90) § | 0.84 (0.73–0.97) § | 0.95 (0.87–1.02) | 1.00 (0.90–1.10) |
60–63 | 0.91 (0.80–1.03) | 0.98 (0.85–1.13) | 0.91 (0.84–0.99) § | 0.93 (0.85–1.03) | |
64–67 | 0.92 (0.81–1.04) | 0.96 (0.84–1.10) | 0.90 (0.83–0.98) § | 0.89 (0.81–0.98) § | |
68–71 | 0.94 (0.84–1.06) | 1.02 (0.90–1.16) | 0.96 (0.89–1.04) | 1.02 (0.92–1.13) | |
72–75 | – | – | – | – | |
76–79 | 1.12 (0.99–1.26) | 1.16 (1.02–1.31) § | 1.01 (0.93–1.09) | 1.06 (0.95–1.18) | |
80–83 | 1.21 (1.08–1.36) || | 1.19 (1.04–1.35) § | 1.17 (1.07–1.28) § | 1.22 (1.09–1.37) § | |
84–88 | 1.24 (1.10–1.39) || | 1.18 (1.04–1.34) § | 1.18 (1.09–1.29) || | 1.19 (1.06–1.34) § | |
89–96 | 1.28 (1.14–1.44) || | 1.11 (0.98–1.26) | 1.44 (1.32–1.56) || | 1.43 (1.29–1.59) || | |
97–117 | 1.48 (1.32–1.65) || | 1.30 (1.14–1.47) || | 2.06 (1.89–2.25) || | 1.85 (1.66–2.07) || | |
Heart Failure Hospitalizations (RR) | 47–59 | 0.68 (0.49–0.93) § | 0.68 (0.48–0.97) § | 0.79 (0.57–1.08) | 0.88 (0.66–1.17) |
60–63 | 0.77 (0.56–1.06) | 0.87 (0.62–1.23) | 0.84 (0.59–1.19) | 0.97 (0.70–1.36) | |
64–67 | 0.72 (0.52–0.99) § | 0.73 (0.52–1.03) | 0.65 (0.47–0.89) § | 0.66 (0.50–0.86) § | |
68–71 | 0.96 (0.73–1.28) | 1.02 (0.76–1.38) | 0.86 (0.59–1.26) | 0.98 (0.72–1.33) | |
72–75 | – | – | – | – | |
76–79 | 1.18 (0.89–1.56) | 1.23 (0.91–1.64) | 0.92 (0.65–1.30) | 1.19 (0.81–1.76) | |
80–83 | 1.27 (0.97–1.68) | 1.20 (0.89–1.62) | 1.05 (0.75–1.45) | 1.20 (0.90–1.61) | |
84–88 | 1.38 (1.06–1.80) § | 1.23 (0.92–1.64) | 1.06 (0.76–1.46) | 1.24 (0.92–1.68) | |
89–96 | 1.33 (1.01–1.74) § | 1.09 (0.81–1.46) | 1.38 (1.00–1.92) | 1.61 (1.18–2.21) § | |
97–117 | 1.85 (1.43–2.39) || | 1.64 (1.24–2.17) § | 2.11 (1.53–2.92) || | 2.29 (1.65–3.17) || |