Abstract
BACKGROUND: Resting heart rate has been shown to predict risk of cardiovascular disease; its association with diabetes remains unclear, particularly in non-Western populations. METHODS: We evaluated the association between resting heart rate and risk of type 2 diabetes in the Shanghai Women's Health Study, a population-based prospective cohort study. The analysis included 47 571 Chinese women with no prior history of diabetes, cancer, cardiovascular disease or thyroid dysfunction at the time when resting heart rate was measured. Incident diabetes was ascertained through biennial in-person interviews. RESULTS: During a mean follow-up of 4.9 years, 849 women developed type 2 diabetes. For heart rate categories of < or =68, 69-72, 73-76, 77-80 and >80 beats/min, the incidence rates of diabetes per 1000 person-years were 2.91, 3.31, 3.71, 4.16 and 5.34, respectively. The multivariable-adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] for diabetes across increasing heart rate categories were 1, 1.21 (0.99-1.47), 1.30 (1.05-1.62), 1.37 (1.12-1.69) and 1.60 (1.28-2.00), respectively. Further analyses of the joint effects of heart rate with body mass index (BMI), waist-hip ratio (WHR) and blood pressure (BP) showed increased risk of diabetes with increasing heart rate in all categories of BMI, WHR or BP. The combinations of the highest heart rate category with highest BMI, WHR or BP category were associated with the highest HRs, ranging from 4.81 to 6.34. CONCLUSIONS: A high resting heart rate is independently associated with an increased risk of type 2 diabetes in women. The combinations of high heart rate with high BMI, WHR or BP level are associated with a substantially increased risk.