ArticleClinical research in cardiology : official journal of the German Cardiac Society2019
Heart rate, mortality, and the relation with clinical and subclinical cardiovascular diseases: results from the Gutenberg Health Study.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Genetic insights into resting heart rate and its role in cardiovascular disease.Nature communications · 2023Pooled it
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- Ten-Year Results of a Single-Center Trial Investigating Heart Rate Control with Ivabradine or Metoprolol Succinate in Patients After Heart Transplantation.Journal of cardiovascular development and disease · 2025Article
- Characterization of cardiac autonomic dysfunction in acute Schizophrenia: a cluster analysis of heart rate variability parameters.Schizophrenia (Heidelberg, Germany) · 2025Article
- Cardiometabolic Aspects of Congenital Adrenal Hyperplasia.Endocrine reviews · 2025Review
- Development of a predictive model for postoperative major adverse cardiovascular events in elderly patients undergoing major abdominal surgery.BMC surgery · 2024Article
- Article
- Chronic disease outcome metadata from German observational studies - public availability and FAIR principles.Scientific data · 2023Article
- Initial in-hospital heart rate is associated with long-term survival in patients with acute ischemic stroke.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Article
- Five-year results of heart rate control with ivabradine or metoprolol succinate in patients after heart transplantation.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Article
- Demonstrating the Applicability of Smartwatches in PMSensors (Basel, Switzerland) · 2021Article
- Association of heart rate with cardiovascular events and mortality in hypertensive and normotensive population: a nationwide prospective cohort study.Annals of translational medicine · 2021Article
- Cryoballoon pulmonary vein isolation-mediated rise of sinus rate in patients with paroxysmal atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Midregional pro atrial natriuretic peptide: a novel important biomarker for noise annoyance-induced cardiovascular morbidity and mortality?Clinical research in cardiology : official journal of the German Cardiac Society · 2021Observational
- Sharp rises in FGF23 and hypophosphatemia after intravenous iron administration do not cause myocardial damage.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
- ARNIs: balancing "the good and the bad" of neuroendocrine response to HF.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
- What possibly affects nighttime heart rate? Conclusions from N-of-1 observational data.Digital healthArticle
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundHigher, but also lower resting heart rate (HR), has been associated with increased cardiovascular events and mortality. Little is known about the interplay between HR, cardiovascular risk factors, concomitant diseases, vascular (endothelial) function, neurohormonal biomarkers, and all-cause mortality in the general population. Thus, we aimed to investigate these relationships in a population-based cohort.
methods15,010 individuals (aged 35-74 at enrolment in 2007-2012) from the Gutenberg Health Study were analyzed. Multivariable regression modeling was used to assess the relation between the variables and conditional density plots were generated for cardiovascular risk factors, diseases, and mortality to show their dependence on HR.
resultsThere were 714 deaths in the total sample at 7.67 ± 1.68 years of follow-up. The prevalence of diabetes mellitus, arterial hypertension, coronary and peripheral artery disease, chronic heart failure, and previous myocardial infarction exhibited a J-shaped association with HR. Mortality showed a similar relation with a nadir of 64 beats per minute (bpm) in the total sample. Each 10 bpm HR reduction in HR < 64 subjects was independently associated with increased mortality (Hazard Ratio 1.36; 95% confidence interval 1.06-1.75). This increased risk was also present in HR > 64 subjects (Hazard Ratio 1.29; 95% confidence interval 1.19-1.41 per 10 bpm increase in HR). Results found for vascular and neurohormonal biomarkers exhibited a differential picture in subjects with a HR below and above the nadir. DISCUSSION: These results indicate that in addition to a higher HR, a lower HR is associated with increased mortality.
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