Resting heart rate (RHR) is known as a cardiovascular risk factor (RF), correlated with hypertension, cardiac failure and coronary artery disease. The aim of this study was to assess the risk of all-cause mortality in a general population in a prediction algorithm including RHR as an independent parameter.

Our study population consisted in patients, both women and men, who had consulted from 1995 to 2011 to the Department of Preventive Cardiology (DPC) in a Southwestern French University Hospital. We excluded patients whose age was less than 30 years old and all patients with established history of ischemic heart disease. An algorithm for prediction of risk of mortality in primary prevention was built using Kaplan-Meier statistic and a Cox proportional hazards model.

4885 patients were included. 56% were men and the mean age was 53. After a mean follow up of 8.6 years, 129 deaths were recorded. In multivariate analysis, independent RF were age (Hazard Ratio (HR)=1.06, p<0.001, 95%CI [1.04-1.08]), gender (HR=5.95, p<0.001, 95% CI [3.48-10.19]), diabetes (HR=2.49, p<0.001, 95% CI [1.49-4.16]), hypertension (HR=1.44, p=0.05, 95% CI [1.00-2.08]), LDL-cholesterol>4 mmol/L (HR=2.04, p<0.001, 95% CI [1.402.96]), smoking (HR=2.19, p<0.001, 95% CI [1.49-3.20]), lower educational level (HR=1.81, p=0.01, 95% CI [1.18-2.79]) and resting heart rate> 65 bpm (HR=1.54, p=0.02, 95% CI [1.06-2.24]). A good calibration was obtained (p value NS for Hosmer-Lemeshow %² test). The median predicted risk of mortality was 6.52% and was not significantly different to the observed risk of all cause mortality (6.60%; 95%CI [5.22%-8.34%]).

RHR can be used to predict all-cause mortality in primary prevention and might be evaluated as a simple predictive tool in current practice.