Association between heart rate and cardiovascular death in patients with coronary heart disease: A NHANES-based cohort study

Abstract

Background: Due to the lack of research, this study aimed to assess the association between the specific range of heart rate and cardiovascular (CV) death in coronary heart disease (CHD) patients. Hypothesis: Heart rate of 70–79 bpm may be associated with reduced risk of CV death in CHD patients. Methods: This retrospective cohort study collected the data of CHD patients from the eight cycles of the Health and Nutrition Examination Survey (NHANES). The included patients were divided into four groups: <60, 60–69, 70–79, and ≥80 bpm. The start of follow-up date was the mobile examination center date, the last follow-up date was December 31, 2015. The average follow-up time was 81.70 months, and the longest follow-up time was 200 months. Competing risk models were developed to evaluate the association between heart rate and CV death, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Results: A total of 1648 patients with CHD were included in this study. CHD patients at heart rate of <60 (HR, 1.35; 95% CI, 1.34–1.36), 60–69 (HR, 1.05; 95% CI, 1.04–1.06) or ≥80 (HR, 1.39; 95% CI, 1.38–1.41) bpm had a higher risk of CV death than those at heart rate of 70–79 bpm. Conclusions: Heart rate of <70 or ≥80 bpm was associated with an elevated risk of CV death among CHD patients. Continuous monitoring of heart rate may help to screen for health risks and offer early interventions to corresponding patients.