TY - JOUR
T1 - Resting Heart Rate is a Predictor of Mortality in Chronic Obstructive Pulmonary Disease
AU - Jensen, Magnus T
AU - Marott, Jacob Louis
AU - Lange, Peter
AU - Vestbo, Jørgen
AU - Schnohr, Peter
AU - Nielsen, Olav Wendelboe
AU - Jensen, Jan Skov
AU - Jensen, Gorm Boje
PY - 2012/11/8
Y1 - 2012/11/8
N2 - The clinical significance of high heart rate in COPD is unexplored.We investigated the association between resting heart rate (RHR), pulmonary function, and prognosis in subjects with COPD.16,696 subjects above 40 years from The Copenhagen City Heart Study, a prospective study of the general population, followed for 35.3 years, 10,986 deaths occurring. Analyses were performed using time-dependent Cox-models and net reclassification index (NRI).RHR increased with severity of COPD (p<0.001). RHR was associated with both cardiovascular and all-cause mortality across all stages of COPD (p<0.001).Within each stage of COPD, RHR improved the prediction of median life expectancy; the difference between <65 bpm and >85 bpm was 5.5 years in no COPD, 9.8 years in mild, 6.7 years in moderate, and 5.9 years in severe/very severe, (p<0.001). RHR significantly improved risk prediction when added to GOLD stage, (categorical NRI 4.9%, p=0.01; categoryless NRI 23.0%, p<0.0001), or FEV1 in percent of predicted (categorical NRI 7.8%, p=0.002; categoryless NRI 24.1%, p<0.0001).RHR increases with severity of COPD. RHR is a readily available clinical variable that improves risk prediction in patients with COPD above and beyond that of pulmonary function alone. RHR may be a potential target for intervention in COPD.
AB - The clinical significance of high heart rate in COPD is unexplored.We investigated the association between resting heart rate (RHR), pulmonary function, and prognosis in subjects with COPD.16,696 subjects above 40 years from The Copenhagen City Heart Study, a prospective study of the general population, followed for 35.3 years, 10,986 deaths occurring. Analyses were performed using time-dependent Cox-models and net reclassification index (NRI).RHR increased with severity of COPD (p<0.001). RHR was associated with both cardiovascular and all-cause mortality across all stages of COPD (p<0.001).Within each stage of COPD, RHR improved the prediction of median life expectancy; the difference between <65 bpm and >85 bpm was 5.5 years in no COPD, 9.8 years in mild, 6.7 years in moderate, and 5.9 years in severe/very severe, (p<0.001). RHR significantly improved risk prediction when added to GOLD stage, (categorical NRI 4.9%, p=0.01; categoryless NRI 23.0%, p<0.0001), or FEV1 in percent of predicted (categorical NRI 7.8%, p=0.002; categoryless NRI 24.1%, p<0.0001).RHR increases with severity of COPD. RHR is a readily available clinical variable that improves risk prediction in patients with COPD above and beyond that of pulmonary function alone. RHR may be a potential target for intervention in COPD.
U2 - 10.1183/09031936.00072212
DO - 10.1183/09031936.00072212
M3 - Journal article
SN - 0904-1850
SN - 1399-3003
VL - 42
SP - 341
EP - 349
JO - The European Respiratory Journal
JF - The European Respiratory Journal
IS - 2
ER -