Significance, prognostic value and management of heart rate in hypertension

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Pierre-Yves Courand1, Pierre Lantelme1

  • 1Cardiology Department, European Society of Hypertension Excellence Centre, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Génomique Fonctionnelle de l'Hypertension Artérielle, EA 4173, Université Claude-Bernard Lyon-1, Villeurbanne, France; Hôpital Nord-Ouest, Villefranche-sur-Saône, France.

Archives of Cardiovascular Diseases
|January 21, 2014
PubMed

Insights

Elevated resting heart rate in hypertension may indicate higher cardiovascular risk but isn't a proven modifiable risk factor. Current evidence suggests it's more a marker than a target for intervention in these patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Epidemiology

Background:

  • Resting heart rate (RHR) is a known risk marker and factor in coronary artery disease and heart failure.
  • Its role in hypertensive individuals without overt cardiac disease is less understood.
  • High RHR in hypertension is linked to increased mortality risk in some studies.

Purpose of the Study:

  • To review the pathophysiological effects of heart rate.
  • To evaluate the prognostic value of heart rate in hypertensive patients.
  • To discuss the management of heart rate in this population.

Main Methods:

  • Review of epidemiological studies and clinical trials.
  • Analysis of ambulatory heart rate data.
  • Examination of pathophysiological mechanisms linking heart rate to cardiovascular health.

Main Results:

  • Elevated RHR in hypertensive patients without cardiac disease appears to be primarily a risk marker, not a modifiable risk factor.
  • Intervention trials targeting heart rate reduction have not shown clear benefits in this group.
  • Ambulatory and nighttime heart rate may correlate better with cardiovascular outcomes.

Conclusions:

  • While high RHR indicates risk, current data do not support targeting heart rate for intervention in hypertensive patients without overt cardiac disease.
  • Further research is needed to clarify the role of heart rate management in hypertension.

Keywords:
Fréquence cardiaqueHeart rateHypertensionMortalityMortalitéPrognostic valueValeur pronostique

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