Resting heart rate in middle age and diabetes development in older age.

OBJECTIVE Based on prior research showing inverse associations between heart rate and life expectancy, we tested the hypothesis that adults with higher resting heart rate in middle age were more likely to have diagnosed diabetes or to experience diabetes mortality in older age (>65 years). RESEARCH DESIGN AND METHODS Resting heart rate was measured at baseline (1967-1973) in the Chicago Heart Association Detection Project in Industry. We used Medicare billing records to identify diabetes-related hospital claims and non-hospital-based diabetes expenses from 1992 to 2002 in 14,992 participants aged 35-64 years who were free from diabetes at baseline. Diabetes-related mortality was determined from 1984 to 2002 using National Death Index codes 250.XX (ICD-8 and -9) and E10-E14 (ICD-10). RESULTS After age 65, 1,877 participants had diabetes-related hospital claims and 410 participants had any mention of diabetes on their death certificate. The adjusted (demographic characteristics, cigarette smoking, and years of Medicare eligibility) odds of having a diabetes-related claim was approximately 10% higher (odds ratio [OR] 1.10 [95% CI 1.05-1.16]) per 12 bpm higher baseline heart rate. Following adjustment for BMI and postload glucose at baseline, the association attenuated to nonsignificance. Higher heart rate was associated with diabetes mortality in adults aged 35-49 years at baseline following adjustment for postload glucose and BMI (1.21 [1.03-1.41]). CONCLUSIONS Higher resting heart rate is associated with diabetes claims and mortality in older age and is only due in part to BMI and concurrently measured glucose.