Objective: We set out to examine the association between resting heart rate and haematological factors and blood lipids, all believed to be associated with coronary heart disease.
Methods: In a cross-sectional study, 6016 industrial employees in Israel were screened between 1985 and 1987 for cardiovascular disease risk factors [the CORDIS Study (Cardiovascular Occupational Risk Factors Detection in Israeli Industries)]. Repeated measures of resting heart rates were obtained. Complete data were available for 5393 participants. The lowest mean measure was used to examine the association with individual factors.
Results: For men, of the blood lipids, only triglycerides were independently positively associated with resting heart rate after controlling for all the possible confounding factors (P <0.002). Mean heart rate was higher at elevated triglyceride levels (70 beats/min at ≤ 93mg/dl and 73.3 beats/min at >150mg/dl). Platelet count and haemoglobin were independently positively associated with heart rate (P <0.0001 in both groups). For women, low-density lipoprotein cholesterol and leucocyte count were independently positively associated with resting heart rate (P <0.05 and P = 0.006, respectively).
Conclusion: These associations suggest that the role of resting heart rate as a predictor of coronary heart disease may be partly explained by its association with triglycerides, haemoglobin, platelet count and leucocyte count, which may be confounding factors or intervening variables.
DyerARPerskyVStamlerJOglesbyPShekelleRBBerksonDM: Heart rate as a prognostic factor for coronary heart disease and mortality: Findings in three Chicago epidemiologic studies. Am J Epidemiol1980, 112:736–749.
2.
SchrollMHagerupLM: Risk factors of myocardial infarction and death in men aged 50 at entry. Dan Med Bull1977, 24:252–255.
3.
MedalieJHKahnHANeufeldHNRissEGoldbourtU: Five-year myocardial infarction incidence. II. Association of single variables to age and birth place. J Chronic Dis1973, 26:329–349.
4.
ShurtleffD: Some characteristics related to the incidence of cardiovascular disease and death: Framingham Study, 18 year follow-up. Section 30. The Framingham Study – an Epidemiological Investigation of the Cardiovascular Diseases. Edited by KannelWBGordonT.Washington DC: US DHEW; 1974.
5.
FriedmanGDKlatskyALSiegelaubAB: Predictors of sudden cardiac death. Circulation1975, 51 (suppl III):164–169.
6.
KannelWBKannelCPaffenbargerRSCupplesA: Heart rate and cardiovascular mortality: The Framingham Study. Am Heart J1987, 113:1489–1494.
7.
GillumRFMakucDMFeldmanJJ: Pulse rate, coronary heart disease, and death: The NHANES I Epidemiologic Follow-up Study. Am Heart J1991, 121:172–177.
8.
ManuckSBCarlandFN: Stability of individual differences in cardiovascular reactivity: A thirteen-month follow-up. Physiol Behav1980, 24:621–624.
9.
SteinhausAH: Chronic effects of exercise. Physiol Rev1933, 13:103.
10.
GoldbourtUMedalieJH: Characteristics of smokers, non-smokers and ex-smokers among 10000 adult males in Israel. II. Physiologic, biochemical and genetic characteristics. Am J Epidemiol1977, 105:75–86.
11.
BlackburnHBrozekJTaylorHLKeysA: Comparison of cardiovascular and related characteristics in habitual smokers and non-smokers. Ann N Y Acad Sci1960, 90:277–289.
12.
HigginsMWKjelsbergM: Characteristics of smokers and non-smokers in Tecumseh, Michigan. II. The distribution of selected physical measurements and physiologic variables and the prevalence of certain diseases in smokers and non-smokers. Am J Epidemiol1967, 86:60–77.
13.
ThomasCB: Characteristics of smokers compared with non-smokers in a population of healthy young adults, including observations of family history, blood pressure, heart rate, body weight, cholesterol and certain physiologic traits. Ann Intern Med1960, 53:697–718.
14.
StamlerJRhombergPSchoenbergJAShekelleRBDyerAShekelleS: Multivariate analysis of the relationship of seven variables to blood pressure: Findings from the Chicago Heart Association Detection Projection in Industry, 1967–1972. J Chronic Dis1975, 28:527–548.
15.
StamlerJStamlerRRhombergPDyerABerksonOMReedusW: Multivariate analysis of the relationship of six variables to blood pressure: Findings from Chicago community surveys, 1965–1971. J Chronic Dis1975, 28:499–525.
16.
PaffenbargerRSThorneMCWingAL: Chronic disease in former college students. VIM. Characteristics in youth predisposing to hypertension in later years. Am J Epidemiol1968, 83:25–32.
17.
KannelWBSorlieP: Hypertension in Framingham. In Epidemiology and Control of Hypertension. Edited by PaulO.Miami: Symposia Specialists, 1975: 553–590.
18.
KahnHAMedalieJHNeufeldHNRissEGoldbourtU: The incidence of hypertension and associated factors: The Israeli ischemic disease study. Am Heart J1972, 84:171–182.
19.
GillumRF: The epidemiology of resting heart rate in a national sample of men and women: Associations with hypertension, coronary heart diseases, blood pressure, and other cardiovascular risk factors. Am Heart J1988, 116:163–174.
20.
HaddyFJ: Local control of vascular resistance as related to hypertension. Arch Intern Med1974, 133:916.
21.
DimsdaleJEHerdJA: Variability of plasma lipids in response to emotional arousal. Psychosom Med1982, 44:413–430.
22.
GoldingL: Effects of physical training upon total serum cholesterol levels. Res Q1961, 32:499.
23.
SkinnerJSHolloszyKOCuretonTK: Effects of a program of endurance exercises on physical work. Am J Cardiol1964, 14:747.
24.
OhlssonOHenningsenNCMalmquistI: Blood pressure, heart rate and plasma albumin in relatives of hypertensive patients. Acta Med Scand1981, 209:445–450.
25.
TibblinGBergentzSEBjureJWilhelmsenL: Hematocrit, plasma protein, plasma volume, and viscosity in early hypertensive disease. Am Heart J1966, 72:165–176.
26.
Chang-YeungMBuncioAD: Leukocyte count, smoking, and lung function. Am J Med1984, 76:31–37.
27.
FriedmanGDSiegelaubABSeltzerCCFeldmanRCollenMF: Smoking habits and the leukocyte count. Arch Environ Health1973, 26:137–143.
28.
MartinMJHulleySBBrownerWSKullerLHWentworthD: Serum cholesterol, blood pressure, and mortality: Implications from a cohort of 361 662 men. Lancet1986, ii:933–936.
29.
Lipid Research Clinics Program: The Lipid Research Clinics Coronary Primary Prevention Trial results: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA1984, 251:365–374.
30.
PhillipsAShaperACWhincupPH: Association between serum albumin and mortality from cardiovascular disease, cancer and other causes. Lancet1989, ii:1434–1436.
31.
KullerLHEichnerJEOrchardTJGranditsGAMcCallumLRussellPT: The relation between serum albumin levels and risk of coronary heart disease in the Multiple Risk Factor Intervention Trial. Am J Epidemiol1991, 134:1266–1277.
32.
BirnbaumMLeveinCD: Probable role of normal hemoglobin level as etiologic factor in coronary heart disease. N Y State J Med1961, 61:4213–4218.
33.
BirnbaumM: Normal hemoglobin level and coronary heart disease. Am Heart J1963, 62:136–137.
34.
BurchGDePasqualeN: Erythrocytosis and ischemic myocardial disease. Am Heart J1963, 62:139–140.
35.
Abu-ZeidHAHChapmanJM: The relationship between hemoglobin level and some risk factors in ischemic heart disease. The Los Angeles Heart Study [abstract]. Circulation1973, 48 (suppl 4):9.
36.
FagherBSjögrenASjögrenU: Platelet counts in myocardial infarction, angina pectoris and peripheral artery disease. Acta Med Scand1985, 271:21–26.
37.
EnsrudKGrimmRH: The white blood cell count and risk for coronary heart disease. Am Heart J1992, 124:207–213.
38.
ThaulowEErikssenJSandvikLCohnPF: Blood platelet count is related to cardiovascular death in apparently healthy men [abstract]. Circulation1989, 80 (suppl II):II299.
39.
KeysATaylorHLBlackburnHBrozekJAndersonJTSimonsonE: Mortality and coronary heart disease among men studied for 23 years. Arch Intern Med1971, 128:2010–2014.
40.
GillumRF: Heart rate of black and white youths aged 12–17 years: Associations with blood pressure and other cardiovascular risk factors. J Natl Med Assoc1988, 80:953–960.
41.
WilliamsPTHaskellWLVranizanKMBlaieSNKraussRMSuperkoHR: Associations of resting heart rate with concentrations of lipoprotein subtractions in sedentary men. Circulation1985, 71:441–449.
42.
BønaaKHArnesenE: Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study. Circulation1992, 86:394–405.
43.
HansenLKGrimmRHJrNeatonJD: The relationship of white blood cell count to other cardiovascular risk factors. Int J Epidemiol1990, 19:881–888.
44.
FriedmanGDTekawaIGrimmRHManolioTShannonSGSidneyS: The leukocyte count: Correlates and relationship to coronary risk factors. The CARDIA Study. Int J Epidemiol1990, 19:889–893.
45.
NietoFJSzkloMFolsomARRockRMercuriM: Leukocyte count correlates in middle-aged adults: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol1992, 136:525–537.
46.
GreenMPeledI: Prevalence and control of hypertension in a large cohort of occupationally-active Israelis examined during 1985–1987. The CORDIS Study. Int J Epidemiol1992, 21:676–682.
47.
GoldbourtUKarkJD: The epidemiology of coronary heart disease in the ethnically and culturally diverse population of Israel. A review. Isr J Med Sci1982, 18:1077–1097.
48.
AllainCCPoonLSChanCSGRichmondIYFuPC: Enzymatic determination of total serum cholesterol. Clin Chem1974, 20:470–475.
49.
FriedwaldWTLevyRIFredricksonDS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem1972, 18:499–502.
50.
AymanDGoldshineAD: Blood pressure determinations by patients with essential hypertension: The difference between clinic and home readings before treatment. Am J Med Sci1940, 200:465–474.
51.
FriedmanGDKlatskyALSiegelaubAB: The leukocyte count as a predictor of myocardial infarction. N Engl J Med1974, 290:1275–1278.
52.
GrimmRHNeatonJDLudwingW: Prognostic importance of the white blood cell for coronary, cancer, and all-cause mortality. JAMA1985, 254:1932–1937.
53.
ErnstEHammerschmidtDEBaggeUMatraiADormandyJA: Leukocytes and the risk of ischemic diseases. JAMA1987, 257:2318–2324.
54.
BottigerLECarsonLA: Relation between serum cholesterol and triglyceride concentration and haemoglobin levels in non-anaemic healthy persons. BMJ1972, 3:731–733.
