Aging, Resting Pulse Rate, and Longevity

Jochanan Stessman, MD; Jeremy M. Jacobs, MBBS; Irit Stessman-Lande, BMedSci; Dan Gilon, MD; David Leibowitz, MD


J Am Geriatr Soc. 2013;61(1):40-45. 

In This Article


Clinical characteristics of the study population at ages 70, 78, and 85 are shown in Table 1. As expected, there was a significant increase in the incidence of cardiovascular disease and hypertension and in the use of beta-blockers in the cohort over time. Mean RPR at ages 70, 78, and 85 was 74.3 ± 10.7, 73.1 ± 11.2, and 65.2 ± 10.5 bpm, respectively, in men and 75.1 ± 9.9, 74.5 ± 10.9, and 68.6 ± 10.5 bpm, respectively, in women. The decline in RPR that occurred from age 78 to 85 was significant in both sexes (P < .001). The differences in RPR between the sexes were significant at age 85 (P < .001). Table 2 depicts changes in RPR over time in survivors examined at all three time points. These findings confirm a reduction in RPR in both sexes with aging. RPR was consistently lower in those with IHD at all ages and also in those without diabetes mellitus. At age 85, RPR was significantly lower in subjects with high education, those who were physically active, those who were independent in activities of daily living, those with preserved cognitive function, and those with a diagnosis of IHD or hypertension. RPR was consistently lower in subjects taking beta-blockers than in those who were not (68.8 ± 9.3 vs 75.9 ± 10.1 at 70; 67.8 ± 9.7 vs 75.5 ± 10.9 at 78; 62.1 ± 9.0 vs 70.2 ± 10.4 at 85, P < .001 at all ages).

When examined as a continuous variable, RPR was significantly lower in women aged 70 surviving until 78, both sexes at age 78 surviving until 85, and men at age 85 surviving until age 90 (Table 3). Similarly, when RPR was examined as a dichotomous variable, Kaplan–Meier survival charts demonstrated significantly greater survival associated with lower RPR for women at age 70 to 77, men at age 78 to 84, and both sexes at age 85 to 90 (Figure 1).

Figure 1.

Kaplan–Meier survival charts according to age, sex, and resting pulse rate. Log rank test: Age 70–77, women, P = .03; men P = .52; Age 78–84, women, P = .20; men, P = .002; Age 85–90, women, P = .008; men, P = .002.

To account for the possible confounding effects of beta-blocker therapy, the cohort was divided into subgroups that did and did not take beta-blockers. In subjects treated with beta-blockers, there were no significant differences in RPR between survivors and nonsurvivors, whereas in subjects who did not receive beta-blocker therapy, RPR was significantly lower in female survivors at age 70 and in survivors of both sexes at ages 78 and 85 (Supporting information).

When subjects were divided into subgroups according to level of physical activity with and without use of beta-blockers, there were no significant differences in RPR between physically active and sedentary subjects of either sex at any age (Supporting information).

Table 4 shows the HRs associated with a 10-bpm increase in RPR over the periods 70 to 77, 78 to 84, and 85 to 90. Sex and education were initially adjusted for, and medical covariates, physical activity, beta-blocker use, and the interaction variable of RPR by beta-blocker were subsequently adjusted for. Greater RPR at ages 78 and 85 remained an independent predictor of greater mortality. In the proportional hazards model, neither beta-blocker usage nor the beta-blocker by RPR interaction variable were significant predictors of subsequent mortality.