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Resting heart rate and outcomes in patients with cardiovascular disease: where do we currently stand?

Ian B A Menown1, Simon Davies, Sandeep Gupta

  • 1Craigavon Cardiac Centre, Craigavon, UK. ian.menown@southerntrust.hscni.net

Cardiovascular Therapeutics
|September 8, 2012
PubMed

Insights

Elevated resting heart rate increases cardiovascular risk. Reducing heart rate through lifestyle or medication may lower this risk, especially for those with heart disease or heart failure.

Area of Science:

  • Cardiology
  • Clinical Epidemiology
  • Pharmacology

Background:

  • Large epidemiological studies link elevated heart rate to increased cardiovascular and all-cause mortality in hypertensive and cardiovascular disease patients.
  • Beta-blockers and other heart rate-lowering agents show benefits in acute myocardial infarction and congestive heart failure, potentially due to heart rate reduction.
  • Admission heart rate is an independent risk factor in clinical outcome prediction models like the Global Registry of Acute Coronary Events (GRACE) score.

Purpose of the Study:

  • To critically review the epidemiology of heart rate and cardiovascular risk.
  • To explore potential mechanisms linking elevated resting heart rate to adverse outcomes.
  • To evaluate clinical trial outcomes of pharmacological heart rate reduction.

Main Methods:

  • Review of epidemiological data.
  • Analysis of clinical trial outcomes.
  • Evaluation of pharmacological interventions.

Main Results:

  • Prospective randomized data indicate that reducing resting heart rate in patients with significant coronary heart disease or heart failure (resting heart rate >70 bpm) may decrease cardiovascular risk.
  • Observational data and randomized trial evidence support the role of heart rate reduction in cardiovascular risk management.

Conclusions:

  • Intervention to lower resting heart rate (target >70 bpm) is suggested for patients with coronary heart disease or heart failure.
  • Reduction of elevated resting heart rate via lifestyle modifications and/or pharmacological therapy should be considered a key component of secondary prevention in cardiovascular disease patients.
Abstract

Keywords:
AnginaBeta-blockersCalcium channel blockersCardiovascular riskCoronary artery diseaseHeart failureIf Channel blockers

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