Resting heart rate and risk of type 2 diabetes: A prospective cohort study and meta-analysis

Dong Hoon Lee, Leandro Fórnias Machado de Rezende, Frank B. Hu, Justin Y. Jeon, Edward L. Giovannucci

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22 Citations (Scopus)


Background: Positive association between resting heart rate (RHR) and risk of type 2 diabetes (T2D) has been documented in several studies. However, whether RHR is an independent predictor of T2D and its potential interaction with other risk factors of T2D remain unclear. Methods: We conducted a prospective cohort study of 31 156 men from the Health Professionals Follow-up Study (1992-2012). Cox proportional hazard model was used to examine the association between RHR and T2D risk. We further examined whether this association is modified by known risk factors. Lastly, we conducted a meta-analysis of prospective cohort studies. Results: During 505 380 person-years of follow-up, we identified 2338 incident T2D cases. The multivariable-adjusted hazard ratio (HR) comparing the highest vs lowest categories of RHR was 1.69 (95% confidence interval [CI], 1.43-2.01). Increase in 10 bpm of RHR was associated with 19% increased risk of T2D in the fully adjusted model (HR, 1.19; 95% CI, 1.14-1.24). The HRs of T2D associated with RHR were stronger among those with normal weight or without hypertension (P interaction < 0.001). Moreover, RHR with other known risk factors cumulatively increased T2D risk. A meta-analysis consistently showed a positive association between RHR and T2D risk (the summary relative risk [RR] for highest vs lowest RHR, 1.53; 95% CI, 1.26-1.86, n = 12, the summary RR per 10 bpm increase, 1.17; 95% CI, 1.09-1.26, n = 13). Conclusions: High RHR was independently associated with increased risk of T2D. Our findings suggest that RHR, with other known risk factors, could be a useful tool to predict T2D risk.

Original languageEnglish
Article numbere3095
JournalDiabetes/Metabolism Research and Reviews
Issue number2
Publication statusPublished - 2019 Feb

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health (UM1 CA167552 and R01 HL35464). Leandro Fórnias Machado de Rezende receives a doctoral fellowship from Sao Paulo Research Foundation (FAPESP), grants 2014/25614‐4 and 2016/21390‐0.

Funding Information:
National Institutes of Health, Grant/Award Numbers: UM1 CA167552 and R01 HL35464; Sao Paulo Research Foundation (FAPESP), Grant/Award Numbers: 2014/ 25614‐4 and 2016/21390‐0

Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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