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Resting Heart Rate in Middle Age and Diabetes Development in Older Age

¹ Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
² Department of Health Economics and Management, Guanghua School of Management, Peking University, Beijing, China
³ Department of Medicine (Endocrinology), Feinberg School of Medicine, Northwestern University

carnethon{at}northwestern.edu

ABSTRACT

Objective: Based on prior research showing inverse associations between heart rate (HR) and life expectancy, we tested the hypothesis that adults with higher resting HR in middle age were more likely to have diagnosed diabetes or experience diabetes mortality in older age (>65 years).

Research Design and Methods: Resting HR was measured at baseline (1967–73) in the Chicago Heart Association (CHA) Detection Project in Industry Study. We used Medicare billing records to identify diabetes-related hospital claims and non-hospital based diabetes expenses from 1992–2002 in 14,992 participants aged 35–64 years who were free from diabetes at baseline. Diabetes-related mortality was determined from 1984–2002 using National Death Index codes 250.XX (ICD-8 and -9) and E10–E14 (ICD-10).

Results: After age 65, 1877 participants had diabetes-related hospital claims and 410 participants had any mention of diabetes on their death certificate. The adjusted (demographic characteristics, cigarette smoking, and years of Medicare eligibility) odds of having a diabetes related claim was approximately 10% higher (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.05–1.16) per 12 bpm higher baseline heart rate. Following adjustment for body mass index (BMI) and post-load glucose at baseline, the association attenuated to non-significance. Higher heart rate was associated with diabetes mortality in adults aged 35-49 at baseline following adjustment for post-load glucose and BMI (OR = 1.21, 95% CI: 1.03–1.41).

Conclusions: Higher resting HR is associated with diabetes claims and mortality in older age, and is only due in part to BMI and concurrently-measured glucose.

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