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Resting heart rate: a modifiable prognostic indicator of cardiovascular risk and outcomes?

J Malcolm Arnold1, David H Fitchett, Jonathan G Howlett

  • 1University of Western Ontario, London, Canada. malcolm.arnold@hsc.on.ca

The Canadian Journal of Cardiology
|May 28, 2008
PubMed

Insights

Elevated resting heart rate predicts clinical events, but direct causation is unclear. New pure heart rate-reducing drugs, selective I(f) inhibitors, aim to confirm this link and its impact on cardiovascular outcomes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Epidemiology

Background:

  • Elevated resting heart rate is increasingly recognized as a predictor of clinical events.
  • Current heart rate-lowering drugs, like beta-blockers, have multiple mechanisms, complicating direct causal inference.
  • A causal link between elevated heart rate and cardiovascular outcomes requires further investigation.

Purpose of the Study:

  • To review the evidence linking elevated resting heart rate to cardiovascular risk.
  • To discuss the role of novel pharmacological agents in establishing causality.
  • To examine ongoing clinical trials investigating heart rate reduction and cardiovascular outcomes.

Main Methods:

  • Review of epidemiological studies and clinical trial data.
  • Analysis of the pharmacological profile of selective I(f) inhibitors.
  • Discussion of current clinical trials designed to test the heart rate hypothesis.

Main Results:

  • Growing evidence supports elevated resting heart rate as a cardiovascular risk factor.
  • Selective I(f) inhibitors offer a 'pure' approach to heart rate reduction.
  • Clinical trials are underway to confirm the causal relationship between heart rate and cardiovascular events.

Conclusions:

  • Further research is needed to definitively establish elevated heart rate as a modifiable cardiovascular risk factor.
  • Selective I(f) inhibitors represent a promising therapeutic strategy for investigating this link.
  • Confirming causality could lead to new treatment paradigms for cardiovascular disease prevention.

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