,Heart Rate Distribution and Cause-specific Death in General Population of South China

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Objectives To analyses heart rate (HR) distribution of healthy adults in the south China community and evaluate relative risk of HR to total cause of death and cardiac cerebral vascular death. Methods Analytical data come from the baseline survey and follow-up visits in the PRC-USA Collaborative Study of Cardiovascular Epidemiology in urban and rural samples of Guangzhou. The baseline survey was initiated in 1983 and 1984, and rescanned in 1987 and 1988. Since 1991 Follow-up visits for endpoint events were carried once every two years.Average follow-up year was 16.2 from baseline to 2000.People excluded from cardiac cerebral vascular disease, diabetes and other various chronic diseases were regarded as "healthy adults". Heart rates of these subjects were measured on resting electrocardiogram.Endpoint evens include: total cause of death, first attack of coronary disease and cerebral vascular events.SAS software was used for analysis. Cox Proportional Hazards model was used to evaluate the impact of HR on total death and cardiac cerebral vascular disease.Results A total of 4570 men and women aged 35-55years from urban and rural Guangzhou were investigated. 3493 healthy subjects were enrolled in the analysis, including 1694 men and 1799 women. Mean of theHRis (67.9±10.6) beats/min (bpm) in the whole population, ( 66.3 ± 10.7 ) bpm in men and (69.3 ±10.4) in women. The 5th percentile of the HR was 51 in men and 54 in women. The 95th percentile of the HR was 85 in men and 88 in women. Single correlation analysis showed there was negative relationship between age and HR, but it was only statistical significant in female. Analysis with Cox Proportional Hazards model show that HR < 50 bpm tops the risk of total causes of death (1.725)and HR 50-59 bpm decreased the risk of total causes of death (0.843).Relative risk of cardiac cerebral vascular events exceeds 1 when HR < 50 and >90 bpm (1.486 and 7.008 respectively). It was less than 1 in other groups but there was no significant difference between each group. Conclusions Traditional normal range of HR in adult should be adjusted. In certain extent lower HR is advantageous to decrease cardiac cerebral vascular events, total causes of death and has better prognosis.
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