Assessment of Association of Increased Heart Rates to Cardiovascular Events among Healthy Subjects in the United States: Analysis of a Primary Care Electronic Medical Records Database

Objective. To determine whether increases in heart rates (HRs) over time leads to adverse cardiovascular (CV) events among "healthy subjects." Methods. This retrospective cohort study used the GE Centricity EMR database. "Healthy subjects" were defined as those with Charlson Comorbidity Index (CCI) score = 0 and Chronic Disease Score (CDS) = 0 at baseline. Subjects were followed for 3 years post the first date of a clinical encounter between the patient and provider. Those aged ≥18 years old with baseline HR and ≥2 post-index HR readings were identified between 01/01/1996 to 03/30/2007. Results. There were 93,952 "healthy subjects" at baseline (median age 42 years; 67.2% women; mean HR was 75.8 (SD: 11) bpm); 20.7% with a mean HR at baseline of 76.3 (SD: 11.3) bpm (median age 45; 63 women) experienced a CV event during 3 years of follow-up. The mean HR was higher among those with a CV event (76.3 bmp) compared to those without a CV event (75.7 bpm). A Cox regression model indicated that an increase in HR by 5 bpm was associated with a 1% increase in CV event risk. Conclusions. Elevated HRs are associated with an increased likelihood of CV events among "healthy subjects".