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Related Concept Videos

Hypertension I: Introduction01:28

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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
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Related Experiment Video

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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
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What is the Target Resting Heart Rate in Guidelines on Hypertension?

Goran Koracevic1,2, Milovan Stojanovic2,3, Miloje Tomasevic4,5

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|March 25, 2026
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Summary

High resting heart rate (RHR) is a significant cardiovascular risk factor in hypertension (HTN) that current guidelines inadequately address. Future guidelines should incorporate RHR management for better patient outcomes.

Keywords:
Arterial hypertensionantihypertensive therapybeta blockersblood pressure.cardiovas-cular riskguidelinesheart failureresting heart rate

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Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Guidelines

Background:

  • Elevated blood pressure (BP) and increased resting heart rate (RHR) are recognized as independent risk factors impacting prognosis in patients with arterial hypertension (HTN).
  • Current hypertension guidelines offer limited information regarding the significance of RHR and its management.
  • A substantial portion of the hypertensive population, estimated at 30-38%, experiences elevated RHR, highlighting a gap in clinical recommendations.

Purpose of the Study:

  • To evaluate the acknowledgment of high RHR significance in hypertension (HTN) guidelines.
  • To determine if guidelines recommend decreasing RHR during chronic antihypertensive treatment.
  • To identify preferred antihypertensive medications for reducing RHR and ascertain treatment thresholds and targets for RHR in HTN.

Main Methods:

  • Systematic review and analysis of key international hypertension guidelines.
  • Assessment of guideline content concerning RHR acknowledgment, treatment recommendations, preferred medications, and target values.
  • Literature search to identify evidence supporting RHR management in hypertensive patients.

Main Results:

  • Hypertension guidelines largely fail to acknowledge the significance of elevated RHR as a cardiovascular risk factor.
  • There is a scarcity of recommendations for decreasing RHR in chronic antihypertensive treatment.
  • Specific guidance on preferred medications to lower RHR, treatment thresholds, and target RHR values is notably absent in current guidelines.

Conclusions:

  • Current hypertension guidelines inadequately address the role and management of elevated resting heart rate.
  • There is a compelling need to incorporate RHR assessment and management strategies into future hypertension guidelines.
  • Further research is required to establish the prognostic benefits of reducing high RHR in patients with hypertension.