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Original research article
Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality
  1. Mathias Seviiri1,
  2. Brigid M Lynch1,2,3,
  3. Allison M Hodge1,2,
  4. Yi Yang1,2,
  5. Danny Liew4,
  6. Dallas R English1,2,
  7. Graham G Giles1,2,
  8. Roger L Milne1,2,
  9. Pierre-Antoine Dugué1,2
  1. 1 Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
  2. 2 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  4. 4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Pierre-Antoine Dugué, Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3004, Australia; pdugue{at}


Objective Most studies investigating the association between resting heart rate (RHR) and mortality have focused on cardiovascular disease (CVD) mortality, and measured RHR at only one time point. We aimed to assess associations of RHR and changes in RHR over approximately a decade with overall and cause-specific mortality.

Methods We used data from participants in the Melbourne Collaborative Cohort Study with RHR measures at baseline (1990–1994; n=41 386; 9846 deaths) and at follow-up (2003–2007; n=21 692; 2818 deaths). RHR measures were taken by trained staff, using Dinamap monitors. Cox models were used to estimate HR and 95% CI for the associations between RHR and mortality. Vital status and cause of death were ascertained until August 2015 and December 2013, respectively.

Results After adjustment for confounders, including blood pressure and known medical conditions but not arrhythmias or atrial fibrillation, RHR was associated with a higher risk of death of similar magnitude for CVD (HR per 10 beats per minute (bpm)=1.11, 95% CI 1.07 to 1.16), cancer (HR=1.10, 95% CI 1.06 to 1.13) and other causes (HR=1.20, 95% CI 1.16 to 1.25). Higher mortality was observed for most cancer sites, including breast (HR=1.16, 95% CI 1.03 to 1.31), colorectal (HR=1.18, 95% CI 1.08 to 1.29), kidney (HR=1.27, 95% CI 1.03 to 1.57) and lung cancer (HR=1.19, 95% CI 1.10 to 1.29). Temporal increases in RHR were associated with higher mortality, particularly for individuals whose RHR increased by more than 15 bpm.

Conclusions RHR and changes in RHR over a decade are associated with mortality risk, including from causes other than CVD such as breast, colorectal or lung cancer. Monitoring of RHR may have utility in identifying individuals at higher mortality risk.

  • cardiac risk factors and prevention
  • epidemiology

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  • Contributors Study concept and design: MS, BML, YY, P-AD. Acquisition of data: DRE, GGG. Analysis and interpretation of data: MS, BML, AMH, YY, DL, DRE, GGG, RLM, P-AD. Drafting of the manuscript: MS, BML, P-AD. Critical revision of the manuscript for important intellectual content: MS, BML, AMH, YY, DL, DRE, GGG, RLM, P-AD. Statistical analysis: MS, P-AD. Study supervision/guarantor: P-AD. All authors approved the final manuscript submitted and they approved the authorship list.

  • Funding The MCCS cohort recruitment was funded by VicHealth and Cancer Council Victoria. The MCCS was further supported by the Australian NHMRC grants 209057 and 396414, and by infrastructure provided by Cancer Council Victoria. BML is supported by an NBCF Fellowship (ECF 15-012).

  • Competing interests None declared.

  • Ethics approval The Human Research Ethics Committee at Cancer Council Victoria approved the study protocol.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Enquiries about statistical code can be directed to the corresponding author.

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