Predictive value of ambulatory heart rate in the Japanese general population: the Ohasama study

J Hypertens. 2008 Aug;26(8):1571-6. doi: 10.1097/HJH.0b013e3283041172.


Background: Resting heart rate can predict cardiovascular disease mortality or all-cause mortality. Because of the effect of the alert reaction, heart rates measured out-of-office should have better predictive power than those obtained at clinics. However, only a few studies have described the relationship between heart rate measured by ambulatory blood pressure monitoring devices and cardiovascular disease prediction.

Methods: We studied 1444 individuals from the Japanese general population who did not have a history of cardiovascular diseases including arrhythmia. We used multiple adjusted Cox proportional hazards to calculate the mortality risk of daytime heart rate, night-time heart rate, and the day-night heart rate dip ratio [day-night heart rate dip ratio = (daytime heart rate--night-time heart rate)/daytime heart rate x 100].

Results: After 12 years of follow-up, 101, 195, and 296 participants died due to cardiovascular diseases, noncardiovascular diseases, and all causes, respectively. As shown by others, neither daytime nor night-time heart rate predicted cardiovascular disease mortality, whereas both predicted noncardiovascular disease mortality. The day-night heart rate dip ratio was significantly related to all-cause mortality. When night-time heart rate and day-night heart rate dip ratio were simultaneously included into the same Cox model, only night-time heart rate significantly and independently predicted all-cause mortality (relative hazard per 10 bpm increase = 1.29, 95% confidence interval, 1.07-1.54).

Conclusion: Night-time heart rate value seems to have the most important predictor of all-cause mortality among ambulatory heart rate parameters in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asians / statistics & numerical data*
  • Blood Pressure Monitoring, Ambulatory*
  • Cardiovascular Diseases / ethnology*
  • Cardiovascular Diseases / mortality*
  • Circadian Rhythm
  • Female
  • Follow-Up Studies
  • Heart Rate*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Rest