The clinical significance of high heart rate in COPD is unexplored.We investigated the association between resting heart rate (RHR), pulmonary function, and prognosis in subjects with COPD.16,696 subjects above 40 years from The Copenhagen City Heart Study, a prospective study of the general population, followed for 35.3 years, 10,986 deaths occurring. Analyses were performed using time-dependent Cox-models and net reclassification index (NRI).RHR increased with severity of COPD (p<0.001). RHR was associated with both cardiovascular and all-cause mortality across all stages of COPD (p<0.001).Within each stage of COPD, RHR improved the prediction of median life expectancy; the difference between <65 bpm and >85 bpm was 5.5 years in no COPD, 9.8 years in mild, 6.7 years in moderate, and 5.9 years in severe/very severe, (p<0.001). RHR significantly improved risk prediction when added to GOLD stage, (categorical NRI 4.9%, p=0.01; categoryless NRI 23.0%, p<0.0001), or FEV1 in percent of predicted (categorical NRI 7.8%, p=0.002; categoryless NRI 24.1%, p<0.0001).RHR increases with severity of COPD. RHR is a readily available clinical variable that improves risk prediction in patients with COPD above and beyond that of pulmonary function alone. RHR may be a potential target for intervention in COPD.
European Respiratory Journal, 2012, Vol 42, Issue 2, p. 341-349