Abstract
The aim of this study was to investigate the association between baseline resting heart rate (RHR) and all-cause death in the China Stroke Primary Prevention Trial (CSPPT). A post hoc analysis was conducted using data from 20,648 hypertensive adults without cardiovascular disease in the CSPPT and with baseline RHR data available. Over a median follow-up duration of 4.5 years, the baseline RHR and risk for all-cause death had a nonlinear relationship. The risk of all-cause death was higher in participants with an RHR ≥85 bpm (hazard ratio 1.42; 95% confidence interval 1.03-1.96, p = .031) than in those with a baseline RHR of 75-80 bpm. The effect of RHR on all-cause death during the treatment period was modified by the folate level (p = .020) and systolic blood pressure (SBP) during treatment(p = .056). The effect of RHR on the risk of all-cause death was stronger when the folate level was low than when it was high; the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75-80 bpm. RHR had a greater effect on the risk of all-cause death when SBP during treatment was well controlled than when it was not; again, the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75-80 bpm. A higher baseline RHR resulted in an increased risk of all-cause mortality in Chinese adults with hypertension but no history of stroke or myocardial infarction.