Effect of baseline resting heart rate on the risk of all‐cause death in Chinese patients with hypertension

The aim of this study was to investigate the association between baseline resting heart rate (RHR) and all‐cause death in the China Stroke Primary Prevention Trial (CSPPT). A post hoc analysis was conducted using data from 20,648 hypertensive adults without cardiovascular disease in the CSPPT and with baseline RHR data available. Over a median follow‐up duration of 4.5 years, the baseline RHR and risk for all‐cause death had a nonlinear relationship. The risk of all‐cause death was higher in participants with an RHR ≥85 bpm (hazard ratio 1.42; 95% confidence interval 1.03–1.96, p = .031) than in those with a baseline RHR of 75–80 bpm. The effect of RHR on all‐cause death during the treatment period was modified by the folate level (p = .020) and systolic blood pressure (SBP) during treatment(p = .056). The effect of RHR on the risk of all‐cause death was stronger when the folate level was low than when it was high; the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75–80 bpm. RHR had a greater effect on the risk of all‐cause death when SBP during treatment was well controlled than when it was not; again, the risk was higher when the RHR was < 75 bpm or ≥80 bpm than when it was 75–80 bpm. A higher baseline RHR resulted in an increased risk of all‐cause mortality in Chinese adults with hypertension but no history of stroke or myocardial infarction.