Sex- and age-dependent relationships between resting heart rate and cognitive impairment: a population-based cross-sectional study in rural China.
8 affiliations
- 1Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Rd, Xi'an, 710061, China.
- 2Huyi Hospital of Traditional Chinese Medicine, Xi'an, China.
- 3Department of Neurology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Rd, Shenyang, 110001, China. [email protected].
- 4Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Chengdu, Sichuan, China. [email protected].
- 5Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Rd, Xi'an, 710061, China. [email protected].
- 6Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. [email protected].
- 7Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Rd, Xi'an, 710061, China. [email protected].
- 8Department of Human Anatomy and Histoembryology, Nanjing University of Chinese Medicine, 138 Xianlin Rd, Nanjing, 210023, China. [email protected].
Abstract
Background
Resting heart rate (RHR) is an important risk factor for cardiovascular diseases (CVD) and has been linked to cognitive impairment (CI), but evidences remain inconsistent. Given that both cardiovascular regulation and cognitive function differ by sex and age, these factors may modify the RHR-CI association. This study aimed to examine this relationship and its potential sex- and age-specific differences in a general Chinese population.Methods
This population-based cross-sectional study included 1309 participants from rural areas of northwestern China. RHR was obtained from a standard 12-lead electrocardiogram. CI was diagnosed with Mini-Mental State Examination scores below the cutoff value. RHR data were fitted as restricted cubic spline to explore potential non-linear relationships. Stratified analyses by sex, age (50-69 years vs ≥ 70 years) and combined were performed.Results
Two hundred twenty five (17.2%) participants met criteria for CI. We found an independent and prominent U-shaped relationship between RHR and CI in female within 50-69 years (Poverall = 0.01, Pnon-linear = 0.003), while other subgroups showed no significant relations. Further results showed that in female within 50-69 years, both lower (≤ 70 bpm) and higher RHR group (≥ 81 bpm) were associated with increased risk for CI (vs. 71-80 bpm) (≤ 70 bpm vs 71-80 bpm vs ≥ 81 bpm: 19.3% vs 10.7% vs 18.5%, P = 0.011; ≤ 70 bpm vs 71-80 bpm: OR = 2.061(1.225-3.467), P = 0.006; ≥ 81 bpm vs 71-80 bpm: OR = 1.692(0.949-3.015), P = 0.075). This association remained significant after excluding participants with abnormal RHR or with CVD or cerebrovascular diseases.Conclusions
The relationship between RHR and CI was highly dependent on sex and age. An independently U-shaped relationship existed only in female within 50-69 years, but no relations were found in other participants. These findings highlight the importance of considering demographic heterogeneity when evaluating the relationship between RHR and CI.
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BibTeX
@article{shang2026agedependent,
title = {{Sex- and age-dependent relationships between resting heart rate and cognitive impairment: a population-based cross-sectional study in rural China.}},
author = {Suhang Shang and Liangjun Dang and Ling Gao and Shan Wei and Yi Zhao and Ningwei Hu and Wei Peng and Ye Yuan and Jingyi Wang and Jin Wang and Hong Lv and Qiumin Qu and Ziyu Liu},
journal = {BMC neurology},
year = {2026},
month = jul,
doi = {10.1186/s12883-026-05194-9},
url = {https://europepmc.org/article/MED/42958496},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Sex- and age-dependent relationships between resting heart rate and cognitive impairment: a population-based cross-sectional study in rural China.
AU - Suhang Shang
AU - Liangjun Dang
AU - Ling Gao
AU - Shan Wei
AU - Yi Zhao
AU - Ningwei Hu
AU - Wei Peng
AU - Ye Yuan
AU - Jingyi Wang
AU - Jin Wang
AU - Hong Lv
AU - Qiumin Qu
AU - Ziyu Liu
PY - 2026
DA - 2026/07/25
JO - BMC neurology
DO - 10.1186/s12883-026-05194-9
UR - https://europepmc.org/article/MED/42958496
AB - Background Resting heart rate (RHR) is an important risk factor for cardiovascular diseases (CVD) and has been linked to cognitive impairment (CI), but evidences remain inconsistent. Given that both cardiovascular regulation and cognitive function differ by sex and age, these factors may modify the RHR-CI association. This study aimed to examine this relationship and its potential sex- and age-specific differences in a general Chinese population.Methods This population-based cross-sectional study included 1309 participants from rural areas of northwestern China. RHR was obtained from a standard 12-lead electrocardiogram. CI was diagnosed with Mini-Mental State Examination scores below the cutoff value. RHR data were fitted as restricted cubic spline to explore potential non-linear relationships. Stratified analyses by sex, age (50-69 years vs ≥ 70 years) and combined were performed.Results Two hundred twenty five (17.2%) participants met criteria for CI. We found an independent and prominent U-shaped relationship between RHR and CI in female within 50-69 years (Poverall = 0.01, Pnon-linear = 0.003), while other subgroups showed no significant relations. Further results showed that in female within 50-69 years, both lower (≤ 70 bpm) and higher RHR group (≥ 81 bpm) were associated with increased risk for CI (vs. 71-80 bpm) (≤ 70 bpm vs 71-80 bpm vs ≥ 81 bpm: 19.3% vs 10.7% vs 18.5%, P = 0.011; ≤ 70 bpm vs 71-80 bpm: OR = 2.061(1.225-3.467), P = 0.006; ≥ 81 bpm vs 71-80 bpm: OR = 1.692(0.949-3.015), P = 0.075). This association remained significant after excluding participants with abnormal RHR or with CVD or cerebrovascular diseases.Conclusions The relationship between RHR and CI was highly dependent on sex and age. An independently U-shaped relationship existed only in female within 50-69 years, but no relations were found in other participants. These findings highlight the importance of considering demographic heterogeneity when evaluating the relationship between RHR and CI.
SN - 1471-2377
ER -