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Resting pulse predicts heart attacks in women

August 23, 2015

Previous studies have shown that resting heart rate predicts coronary events in men. But, for women, the relationship between heart rate and coronary events or stroke remains uncertain.

So researchers in the USA assessed resting heart rate in 129,135 postmenopausal women with no history of heart problems. Risk factors that might be expected to affect heart rate, such as high blood pressure, high cholesterol levels, smoking and alcohol intake were taken into account at the start of the study. The women were monitored for an average of 7.8 years, during which time all hospital stays and coronary events were recorded.

During the study period, 2,281 coronary events (heart attacks and coronary deaths) and 1,877 strokes occurred.

Women with the highest resting heart rate (more than 76 beats per minute) were significantly more likely to suffer a coronary event than women with the lowest resting heart rate (62 beats per minute or less).

Further analysis showed that this association was independent of physical activity, did not differ between white and minority women, or those with or without diabetes, but was stronger in women 50-64 years of age than among women 65 years or older.

There was no such relationship between resting heart rate and stroke.

Resting heart rate is a simple, inexpensive measurement that independently predicts heart attacks and coronary deaths, but not stroke, in postmenopausal women, say the authors. Although the strength of this association is less than cigarette smoking or diabetes, it may be large enough to be clinically meaningful, they conclude.

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The study also found that Medicare beneficiaries with diabetes were more likely to reach the doughnut hole than those with hypertension, and they reached it sooner. Those with more than one chronic illness also were much more likely to reach the doughnut hole ?? 34 percent with both hypertension and diabetes reached it, and 61 percent of those with hypertension, hyperlipidemia, congestive heart failure and diabetes did so.

"Our findings raise concerns about whether people with chronic illnesses who lack doughnut hole coverage are able to effectively manage their conditions," said Dr. Zhang. "Without needed prescriptions, we could potentially see an increase in hospital and physician costs."

To fill the gap, Dr. Zhang and colleagues suggest mandating the coverage of generic drugs in the doughnut hole and off-setting government costs by allowing plans to assess larger co-pays on prescription drugs prior to entering the doughnut hole. Increasing the current initial 25 percent co-pay by 6 to 9 percentage points, they suggest, would finance generic drug coverage in the doughnut hole with up to $10 co-pay for each monthly prescription, thus providing needed protection to seniors who would otherwise face a gap in coverage.

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