Heart rate and mortality in a Japanese general population: An 18-year follow-up study

Yoshihisa Fujiura, Hisashi Adachi, Makoto Tsuruta, David R. Jacobs, Yuji Hirai, Tsutomu Imaizumi

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89 Scopus citations


The predictive power of elevated heart rate for total mortality was evaluated in a Japanese general population. A total of 573 male participants, aged 40 to 64, who underwent a health examination in 1977, were followed until 1994. Heart rate (beats per minute; bpm) was measured using an electrocardiogram. During the 18 years, 82 subjects died; 18 from cerebro-cardiovascular diseases and 36 from cancer. In a multivariate proportional hazards regression model, age, elevated systolic and diastolic blood pressures, antihypertensive medication, heart rate, uric acid, vital capacity (inversely), and serum cholesterol (inversely) were significantly associated with all-cause death. Of these variables, elevated heart rate was the strongest predictor of all-cause death after adjustment for age. Resting heart rate levels were classified into five groups: <60 (G1), 60-69 (G2), 70-79 (G3), 80-89 (G4), and ≥90 (G5) bpm. Heart rates of 60-69 (G2) bpm showed the lowest death rate (14.3%) and heart rate ≥90 (G5) bpm showed the highest death rate (38.2%) after adjustments for age and other confounding factors. The relative risk of G2 versus G5 was 2.68. An increased mortality risk was shown in men whose heart rate was ≥90 bpm. Moreover, a continuous model suggested a graded increase in risk, so that risk is likely elevated even for heart rates less than 90 bpm, and lowest risk may be around 60 bpm.

Original languageEnglish (US)
Pages (from-to)495-500
Number of pages6
JournalJournal of Clinical Epidemiology
Issue number5
StatePublished - 2001

Bibliographical note

Funding Information:
This study was supported in part by the Kimura Memorial Heart Foundation, Fukuoka, Japan. We are grateful to members of the Japan Medical Association of Ukiha, the elected officials and residents of Tanushimaru, and the team of physicians for their help in carrying out the health examinations.


  • All-cause death
  • Cohort
  • Epidemiology
  • Follow-up study
  • Predictive power
  • Resting heart rate


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