Time-updated resting heart rate predicts mortality in patients with COPD

• Published in: Clinical research in cardiology 2020-06, Vol.109 (6), p.776-786
• Main Authors: Omlor, Albert J., Trudzinski, Franziska C., Alqudrah, Mohamad, Seiler, Frederik, Biertz, Frank, Vogelmeier, Claus F., Welte, Tobias, Watz, Henrik, Waschki, Benjamin, Brinker, Titus J., Andreas, Stefan, Fähndrich, Sebastian, Alter, Peter, Jörres, Rudolf A., Böhm, Michael, Bals, Robert
• Format: Article
• Language: English
• Subjects: Aged; Cardiology; Cardiovascular diseases; Cause of Death - trends; Chronic obstructive pulmonary disease; Clinical trials; Diabetes mellitus; Female; Follow-Up Studies; Germany - epidemiology; Health risk assessment; Heart rate; Heart Rate - physiology; Humans; Lung diseases; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Obstructive lung disease; Original Paper; Prognosis; Prospective Studies; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory function; Rest - physiology; Risk Factors; Survival Rate - trends; Time Factors
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-019-01572-1

High resting heart rate (RHR) is associated with higher mortality in the general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). In particular, the time-updated RHR (most recent value before the event) appears informative. This is the first study to investigate the association of time-updated RHR with mortality in COPD. We compared the baseline and time-updated RHR related to survival in 2218 COPD patients of the German COSYCONET cohort (COPD and Systemic Consequences—Comorbidities Network). Patients with a baseline RHR > 72 beats per minute (bmp) had a significantly ( p  = 0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00–1.87) compared to baseline RHR ≤ 72 bpm. The time-updated RHR > 72 bpm was markedly superior (HR 1.79, 1.30–2.46, p  = 0.001). Both, increased baseline and time-updated RHR, were independently associated with low FEV1, low TLCO, a history of diabetes, and medication with short-acting beta agonists (SABAs). In conclusion, increased time-updated RHR is associated with higher mortality in COPD independent of other predictors and superior to baseline RHR. Increased RHR is linked to lung function, comorbidities and medication. Whether RHR is an effective treatment target in COPD, needs to be proven in controlled trials.