Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605949
Poster
Georg Thieme Verlag KG Stuttgart · New York

Resting heart rate percentiles and associated factors in children and adolescents in Germany

G Sarganas
1   Robert Koch-Institut, Abteilung Epidemiologie und Gesundheitsmonitoring, Berlin
2   DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin
,
A Schaffrath Rosario
1   Robert Koch-Institut, Abteilung Epidemiologie und Gesundheitsmonitoring, Berlin
,
H Neuhauser
1   Robert Koch-Institut, Abteilung Epidemiologie und Gesundheitsmonitoring, Berlin
2   DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

Also available at
 

Background:

Resting heart rate (RHR) in children and adolescents decreases with age and is gender-dependent; therefore, percentile-based references are needed. Different reference ranges for normal RHR that are published in pediatric textbooks and guidelines, often lack sources of references. The objective of this study is to present population-based resting heart rate (RHR) percentiles and associated factors in children and adolescents in Germany and to compare them internationally.

Study design:

Standardized RHR measurements with an oscillometric device were obtained from 3- to 17-year-olds who participated in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS 2003 – 2006, n = 11 986). Age and gender-specific RHR percentiles were derived using flexible age-dependent modeling. Linear regressions were used to test associations of RHR and associated factors.

Results:

RHR decreased with age and mean RHR was on average 3.0 bpm higher in girls than in boys (p < 0.01). The 95th RHR-KiGGS-percentile in boys and girls were up to 10 bpm lower than P95 based on pooled heterogeneous international studies and more similar to percentiles based on population data from NHANES (higher or lower by up to 5 bpm, depending on age). Factors independently associated with RHR in both genders were age, SBP, and height in children aged 3 – 10; and age, SBP and high aerobic fitness in adolescents aged 11 – 17 years. In girls, we found an association between RHR and underweight (OR 3.3 and 4.7 for underweight girls aged 3 – 10 and 11 – 17 respectively compared to normal weight girls). Associations between RHR and aerobic fitness, physical activity, and media use were stronger in boys than in girls.

Conclusion:

This study provides population-based RHR percentiles and evidence for gender-dependent associations of cardiovascular risk factors with RHR in children and adolescents, many of which are lifestyle-related.