Elevated heart rate is a recognized independent risk factor for cardiovascular morbidity and mortality, particularly in hypertensive patients.
Does elevated heart rate increase the risk of cardiovascular disease and mortality in hypertensive patients?
Elevated resting heart rate is a common feature in hypertension and serves as a strong, independent risk factor for cardiovascular morbidity, mortality, and metabolic disturbances.
That elevated heart rate (HR) is a risk factor for cardiovascular morbidity and mortality in healthy people as well as in patients with cardiac diseases is supported by numerous epidemiological association studies.1–4 Increased HR has been recognized as a negative prognostic factor independent of many other clinical parameters that can influence the HR, including physical activity scores, left ventricular function, or use of -blockers. Thus, HR appears to satisfy all epidemiological criteria for being considered as a true risk factor, and its predictive value for cardiovascular disease appeared to be as strong as that of most important cardiovascular risk factors. This is particularly true for the results obtained in hypertensive patients. Elevated HR is a common feature among hypertensive individuals.1 Among the young hypertensive subjects participating in the HARVEST study, 15% had a baseline resting HR 85 bpm and 27% had a HR 80 bpm.5 According to the Tensiopulse study, which evaluated 38 145 patients cared for by 2000 general practitioners all across Italy, 30% of the hypertensive patients had a resting HR 80 bpm.6 In a large French population, untreated hypertensive subjects had approximately a 6-bpm faster HR than normotensive individuals.7 Elevated HR is frequently associated with high blood pressure (BP) and metabolic disturbances and increases the risk of new onset hypertension and diabetes.1 Many experimental data obtained both in animals and in human beings support the importance of HR as a true risk factor for atherosclerosis and cardiovascular disease, providing convincing evidence for this pathogenetic mechanism.1–3 The pathogenetic connection between HR and cardiovascular disease has been discussed in several reports1–3,8,9 and is beyond the scope of this review.
Paolo Palatini (Wed,) conducted a review in Hypertension and Cardiovascular Disease. Elevated heart rate vs. Normal heart rate was evaluated on Cardiovascular morbidity and mortality. Elevated heart rate is a recognized independent risk factor for cardiovascular morbidity and mortality, particularly in hypertensive patients.