Association Between Resting Heart Rate And Coronary Artery Disease, Stroke, Sudden Death And Noncardiovascular Diseases: A Meta-Analysis

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Results:

· 523 records were reviewed in full.
· 478 records were excluded for other reasons
· 45 prospective cohort studies were included in this meta-analysis
· 5 studies (38 studies in general populations and 7 studies in populations of patients with hypertension or diabetes
· 30 provided results for coronary artery disease (1 227 511 participants and 18 364 cases)
· 17 provided results for stroke (1 002 667 participants and 11 515 cases
· 12 provided results for non-cardiovascular diseases (443 192 participants and 12 749 cases)
· 10 pro- vided results for all types of cancer (115 388 participants and 5714 cases),
· 7 provided results for non-cardiovascular diseases excluding cancer (81 332 participants and 2174 cases)
· 7 provided results for sudden death (426 332 participants and 563 deaths).
Follow-up duration ranged from 2 to 40 years.

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Discussion:

· High resting heart rate is a marker of sympa-thetic overactivity
· Insulin resistance
· High levels of uric acid
· Lipid abnormalities
· Hypertension

· High resting heart rate could increase hemodynamic stress and shorten the diastolic phase
· Increase mechanical load,
· tensile stress
· low and oscillatory shear stress
· blood pressure and cardiac work
· Increased oxygen consumption
· These direct detrimental effects could cause coronary athero- sclerosis and myocardial ischemia