Time-updated resting heart rate better predictor for all-cause mortality in chronic obstructive pulmonary disease than baseline resting heart rate

High resting heart rate (RHR) is associated with higher mortality in general population and in cardiovascular disease. Less is known about the association of RHR with outcome in chronic obstructive pulmonary disease (COPD). This study investigated the influence of RHR on survival of 2741 COPD patients in the multicentre cohort study COSYCONET (German COPD and Systemic Consequences – Comorbidities Network). Patients with a baseline RHR >72 beats per minute (bbp) had a significantly (p=0.049) higher all-cause mortality risk (adjusted hazard ratio (HR) of 1.37 (1.00-1.87) compared to baseline RHR 72 bpm separates risk more precisely (HR 1.82, 1.22-2.50, p=0.0001) than baseline RHR. In conclusion, an increased RHR is independently associated with a higher mortality in patients with COPD. These results show that RHR, especially time-updated RHR, represents an independent predictor for mortality in COPD. Whether RHR is a treatment target needs to be proven in controlled trials.