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Resting heart rate predicts incident myocardial infarction, atrial fibrillation, ischaemic stroke and death in the general population: the Tromsø Study
  1. Ekaterina Sharashova1,
  2. Tom Wilsgaard1,
  3. Ellisiv B Mathiesen2,
  4. Maja-Lisa Løchen1,
  5. Inger Njølstad1,
  6. Tormod Brenn1
  1. 1Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  2. 2Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  1. Correspondence to Dr Ekaterina Sharashova, Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; ekaterina.e.sharashova{at}


Background Elevated resting heart rate (RHR) increases risk of death overall, but a comprehensive picture of the associations between RHR, cardiovascular morbidity and mortality events has not yet been presented. We aimed to investigate the effect of RHR on the risk of 5 cardiovascular events: incident myocardial infarction (MI), incident atrial fibrillation (AF), incident ischaemic stroke, total death and cardiovascular death in a general population from Norway.

Methods We followed 24 489 men and women from the Tromsø Study 1994–1995, a population-based cohort study, for 18 years, and analysed the association between RHR and the investigated cardiovascular events. Sex-specific Cox regression with time-dependent covariates was applied with the best-fitting fractional polynomials of RHR.

Results Among men, an independent positive relationship was observed for MI and AF (adjusted HR for AF per 20 bpm increase=1.14; 95% CI 1.02 to 1.27). In women, the corresponding HR for MI was 1.23 (1.09 to 1.40). A J-shaped association was observed for ischaemic stroke in women when compared with a RHR of 70 bpm (HR for 50 bpm=1.31; 0.90 to 1.90; HR for 100 bpm=1.32; 1.04 to 1.69). Total and cardiovascular death showed a strong positive association with RHR in men. In women, the pattern for total death was similar.

Conclusions RHR is an independent risk factor for several cardiovascular events. A novel finding is the positive association between RHR and AF in men and the sex difference in association with ischaemic stroke.

  • Epidemiology of cardiovascular disease
  • Cohort studies

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