Mortality Rises With High-Normal Heart Rate, but Exercise Limits Effect

Marlene Busko

June 06, 2016

MEXICO CITY, MEXICO — In a large study of people going for a health checkup in China, those who had a high-normal resting heart rate of 80 to 99 beats per minute (bpm) had a 40% shorter lifespan than those with a desirable heart rate of 60 to 69 bpm[1].

However, the good news is that "15 to 30 minutes of daily moderate exercise (such as brisk walking) could eliminate the increased mortality and reverse this life-span loss," Dr Chi Pang Wen (China Medical University Hospital, Taichung, Taiwan) reported here at the World Heart Federation's World Congress of Cardiology & Cardiovascular Health 2016 (WCC 2016).

"Usually you don't worry about heart rate if it is below 100, clinically," he told heartwire from Medscape. However, this study suggests patients with a heart rate of 80 to 99 bpm have an appreciable risk of earlier death and that a 4- to 8-year loss of life would occur if nothing were done, he added; thus, these patients need counseling about the merits of exercise.

This study reinforces that "physical activity is important in all countries and should be recommended," session moderator Dr Julie Redfern (University of Sydney and the George Institute for Global Health, Australia) agreed in a comment to heartwire . It shows that regular physical activity improves cardiovascular health, including heart rate.

"You don't necessarily have to worry about reducing the heart rate," Wen emphasized. "What I'm showing is by exercising, you reduce the mortality, and that's even more important than heart rate," he said.

Faster Heart Rate, Shorter Lifespan, and Role of Exercise

In an article published in the Lancet in 2011[2], the researchers reported that 15 to 30 minutes a day of moderate physical activity such as brisk walking can extend life expectancy by 3 to 5 years, Wen said.

In the animal kingdom, "the faster the heart rate, the shorter the lifespan," he continued. For example, on average, a mouse or rat has a heart rate of 500 to 700 bpm and lives 2 years, whereas a whale has a heart rate of 6 bpm and lives 80 years.

In humans as in animals, a fast heart rate means the heart has to work harder. For example, if one person has a resting heart rate of 60 bpm and another person has a resting heart rate of 90 bpm, this translates into an extra 315 million beats in 20 years, Wen added.

The researchers aimed to examine the mortality risk of patients with a heart rate in the upper-normal range and whether this risk might be mitigated by being at least minimally active.

They analyzed data from 515,303 adults in the Taiwan MJ Cohort—243,957 men and 261,317 women—who took part in a health-screening program from 1994 to 2008 and were followed until 2011.

The participants were at least 20 years old and had a resting heart rate between 40 and 150 bpm, as determined by ECG. They were also free of known heart disease, cancer, or severe anemia and lived in diverse urban and rural areas of the country.

In this national cohort, the median heart rate was 72 bpm in men and 75 bpm in women (where normal is 60 to 99 bpm), Wen noted. About one in five men and one in four women had a resting heart rate of 80 to 99 bpm.

During a mean follow-up of 8 years, 16,849 of the study participants died, and the participants with a higher normal resting heart rate were more likely to die than their peers with lower resting heart rate, after adjustment for age and other risk factors.

Prevalence of High Normal Heart Rate and Increased Risk of Dying*

  Men Women
Heart rate, bpm Prevalence, % HR Prevalence, % HR
80–89 16.1 1.31 20.4 1.25
90–99 4.6 1.89 5.8 1.50
80–99 20.7 1.44 26.2 1.31
*Hazard ratio (HR) of dying during a mean follow-up of 8 years, compared with a heart rate of 60 to 69 bpm

For every 1-bpm increase in resting heart rate above 70 bpm, participants had a 4-month shorter lifespan.

Compared with having a desirable resting heart rate of 60 to 69 bpm, having a resting heart rate of 80 to 99 bpm was associated with a 5.6-year shorter lifespan in men and a 4.1-year shorter lifespan in women.

However, compared with being inactive, being active was associated with a 5.2-year longer lifespan in men and a 5.1-year longer lifespan in women.

Thus, a quarter of the general population could live longer by doing a minimal amount of exercise, which would reduce "this overlooked risk" of a high-normal resting heart rate, Wen and colleagues conclude.

The authors have declared no relevant financial relationships.

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