Prognostic value of home heart rate for cardiovascular mortality in the general population

Background: Recently, the advantages of self-measurement of blood pressure (BP) at home have been recognized. The same advantages could also be applicable to resting heart rate (HR) values assessed at home using a device designed for home BP measurement. However, there have been no studies investigating whether home HR values predict the risk of cardiovascular disease mortality. We therefore investigated the usefulness of HR values in predicting cardiovascular mortality using a device that allowed self-measurement of BP and HR at home. Methods: The association between the home-measured resting HR and the 10-year risk of cardiovascular mortality was examined in 1780 Japanese individuals greater than or equal to40 years of age who had no significant arrhythmias. A Cox proportional hazards model that adjusted for major risk factors was used. Results: An increase of 5 beats/min in the morning home HR measurement was associated with a 17% increase in the risk of cardiovascular mortality (95% confidence interval 5% to 30%). This relationship was also statistically significant after adjustment for home BP values. Even when home-measured systolic BP was within the normal range (<135 mm Hg), subjects with HR less than or equal to70 beats/min had a higher risk of cardiovascular mortality (relative hazard 2.16, 95% confidence interval 1.21 to 3.85) than those with normal systolic BP and HR values. Conclusions: Self-measurement of HR at home, together with self-measurement of BP, is a simple method of providing useful clinical information for assessing cardiovascular risk. (C) 2004 American Journal of Hypertension, Ltd.