BMJ  2005;330:1105 (14 May), doi:10.1136/bmj.330.7500.1105-a

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Heart rate is a good predictor of sudden cardiac death, study shows

New York

The profile of a person's heart rate, as shown by an exercise electrocardiogram, is a good predictor of sudden death from myocardial infarction, a new study says.

For the study researchers examined data on heart rates before, during, and after exercise in 5713 asymptomatic men employed by the Paris civil service between 1967 and 1972 ( New England Journal of Medicine 2005;352: 1951-8[Abstract/Free Full Text]).

During the period (mean 23 years) to the end of follow-up in 1994 a total of 81 men had died suddenly from myocardial infarction. The risk of sudden death from myocardial infarction was higher in men with a resting heart rate >75 beats per minute than in men with a resting heart rate <60 beats per minute (relative risk 3.92 (95% confidence interval 1.91 to 8.00); higher in men with an increase in heart rate during exercise of <89 beats per minute than in men with an increase of >113 beats per minute (relative risk 6.18 (2.37 to 16.11); and higher in men with a decrease in heart rate of <25 beats per minute at one minute after the end of exercise than in men with a decrease of >40 beats per minute (relative risk 2.20 (1.02 to 4.74)).

An abnormal heart rate profile is directly associated with a particular susceptibility to cardiac arrhythmia and does not reflect the development of atherosclerosis, the authors write. Exercise training can significantly shift the long term prognosis, they add.

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Rapid Responses:

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Is "prevention" worth it? Informing healthy men of comparatively high longterm risk of cardiac sudden death very questionable tactic.

Anne Peticolas
bmj.com, 13 May 2005 [Full text]

Simple Public Health Strategy for Prevention of Sudden Death due to Myocardial Infarction

Suet-Ting Lau
bmj.com, 14 May 2005 [Full text]

Re: Is "prevention" worth it? Informing healthy men of comparatively high longterm risk of cardiac sudden death very questionable tactic.

JohnLeo Zimmer
bmj.com, 14 May 2005 [Full text]