Abstract 16095: Elevated Heart Rate - An Independent Risk Factor for Mortality in Diabetic Men Even after Use of Heart Rate Lowering Medications

Abstract

Introduction: Elevated resting heart rate (rHR) remains an independent risk factor for mortality even after adjustment of traditional risk factors. However very few studies have looked at this association in patients with diabetes mellitus II (DMII) and none have looked at the effect of heart rate lowering agents on the risk. This study was done to answer this.

Methods: The Veterans Affair database was used to identify patients with DMII who had an electrocardiogram (ECG) or three sets of vital signs that included rHRs accessible between January 1, 1995, and January 1, 1997. The rHR was preferably derived from the EKGs during the enrollment period, but if they were not available, an average of three rHRs was used. 2209 patients were identified who were followed up for 5 years. The primary endpoint of the study was combined all-cause mortality and cardiovascular mortality. The secondary endpoint was the all-cause and cardiovascular mortality stratified by use and non use of heart rate lowering medications. Beta blockers, calcium channel blockers and digoxin were included in the category of heart rate lowering medications.

Results: During 14,916 person-years of follow-up, we identified 716 deaths in our analytic population of 2,209 diabetic men with a mean age of 62±10 years and mean average heart rate of 80±12 beats per minute (bpm). In our multivariable Cox proportional hazard models, a rHR of ≥80 bpm was associated with higher mortality which increased with increase in rHR quintiles. The risk remained high even in those who were taking heart rate lowering medications, although lower than those not taking them (Table).

Conclusions: A resting heart rate of ≥80bpms is an independent risk factor of mortality in diabetic men. The risk increased with an increase in rHR and remained significant even after use of heart rate lowering medications.