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Elevated resting heart rate in adolescent men and risk of heart failure and cardiomyopathy.

Journal article
Authors Martin Lindgren
Josefina Robertson
Martin Adiels
Maria Schaufelberger
Maria A I Åberg
Kjell Torén
Margda Waern
N David Åberg
Annika Rosengren
Published in ESC heart failure
Volume 7
Issue 3
Pages 1178-1185
ISSN 2055-5822
Publication year 2020
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Medicine
Pages 1178-1185
Language en
Subject categories Cardiac and Cardiovascular Systems


This study aims to investigate the association of resting heart rate (RHR) measured in late adolescence with long-term risk of cause-specific heart failure (HF) and subtypes of cardiomyopathy (CM), with special attention to cardiorespiratory fitness.We performed a nation-wide, register-based cohort study of all Swedish men enrolled for conscription in 1968-2005 (n = 1 008 363; mean age = 18.3 years). RHR and arterial blood pressure were measured together with anthropometrics as part of the enlistment protocol. HF and its concomitant diagnoses, as well as all CM diagnoses, were collected from the national inpatient, outpatient, and cause of death registries. Risk estimates were calculated by Cox-proportional hazards models while adjusting for potential confounders. During follow-up, there were 8400 cases of first hospitalization for HF and 3377 for CM. Comparing the first and fifth quintiles of the RHR distribution, the hazard ratio (HR) for HF associated with coronary heart disease, diabetes, or hypertension was 1.25 [95% confidence interval (CI) = 1.13-1.38] after adjustment for body mass index, blood pressure, and cardiorespiratory fitness. The corresponding HR was 1.43 (CI = 1.08-1.90) for HF associated with CM and 1.34 (CI = 1.16-1.54) for HF without concomitant diagnosis. There was an association between RHR and dilated CM [HR = 1.47 (CI = 1.27-1.71)] but not hypertrophic, alcohol/drug-induced, or other cardiomyopathies.Adolescent RHR is associated with future risk of HF, regardless of associated aetiological condition. The association was strongest for HF associated with CM, driven by the association with dilated CM. These findings indicate a causal pathway between elevated RHR and myocardial dysfunction that warrants further investigation.

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