Hypertensive disease and heart rate
Authors:
M. Souček; J. Nevrlka
Published in:
Kardiol Rev Int Med 2008, 10(4): 156-158
Overview
High blo od pressure is a significant and independent factor of cardi ovascular morbidity and mortality, but there is also a link between resting he art rate (HR) and mortality which is well documented in both he althy pe ople and in pati ents with hypertensi on, he art failure, non‑fatal myocardi al infarcti on, metabolic syndrome, and in old pe ople. Resting tachycardi a is also one of the factors reducing lifespan. Therefore it appe ars re asonable to reduce both he art rate and myocardi al oxygen consumpti on. Nevertheless, incre ased resting HR is not yet considered a significant risk factor for cardi ovascular dise ases. This is so beca use there are no prospective studi es showing that selective reducti on of HR in non‑cardi ovascular pati ents improves their prognosis. What is, then, the relati on between hypertensi on and he art rate? Beta blockers or calci um channel blockers (verapamil, dilti azem) are currently the most frequently used medicati on for pharmacological control of he art rate. Now we have a new drug which selectively inhibits lf channels localised in the sino atri al node of the he art and significantly reduces he art rate.
Key words:
resting he art rate – hypertensive dise ase – sympathetic activity – cardi ovascular morbidity and mortality – he art rate reducing drugs
Sources
1. Purcell H. He art rate as a target in ischaemic he art dise ase. Eur He art J 1999; 1 (suppl. H): H58– H63.
2. Heidland UE, Stra uer BE. Left ventricular muscle mass and elevated he art rate are associ ated with coronary plaque disrupti on. Circulati on 2001; 104: 1477– 1482.
3. Sajadi eh A, Ni elsen OW, Rasmussen V et al. Incre ased he art rate and reduced he art rate vari ability are associ ated with subclinical inflammati on in middle- aged and elderly subjects with no apparent he art dise ase. Eur He art J 2004; 25: 363– 370.
4. Levine HJ. Rest he art rate and life expectancy. J Am Cardi ol 1997; 30: 1104– 1106.
5. Schamroth L. An Introducti on to Electrocardi ography. 7th ed. Oxford: Blackwell Sci entific Publicati ons 1990.
6. Palatini P. Need for revisi on of the normal limits of resting he art rate. Hypertensi on 1999; 33: 622– 625.
7. Palatini P, Benetos A, Grassi G et al. Identificati on and management of the hypertensive pati ents with elevated he art rate: statement of a Europe an Soci ety of Hypertensi on Consensus Meeting. J Hypertens 2006; 24: 603– 610.
8. Palatini P, Winnicki M, Santonastaso M et al. Reproducibility of he art rate me asured in the clinic and with 24- ho ur intermittent recorders. Am J Hypertens 2000; 13: 92– 98.
9. Levy RL, Hillman CC, Stro ud WD et al. Transi ent hypertensi on: its significance in terms of later development of sustained hypertensi on and cardi ovascular- renal dise ases. JAMA 1944; 126: 829– 833.
10. Widimský J, Fejfarová M, Fejfar Z. Changes of cardi ac o utput in hypertensive dise ase. Kardi ologi e 1957; 31: 381– 389.
11. Gillman MW, Kannel WB, Belanger A et al. Influence of he art rate on mortality among persons with hypertensi on: the Framingham study. Am He art J 1993; 125: 1148– 1154.
12. Juli us S. Effect of sympathetic overactivity on cardi ovascular prognosis in hypertensi on. Eur He art J 1998; 19 (Suppl. F): 14– 18.
13. Kannel WB, Kannel C, Paffenbarger RS et al. He art rate and cardi ovascular mortality: the Framingham Study. Am He art J 1987; 113: 1484– 1489.
14. Kim JR, Ki efe CI, Li u K et al. He art rate and subsequent blo od pressure in yo ung adults. The CARDIA Study. Hypertensi on 1999; 33: 640– 646.
15. Benetos A, Rudnichi A, Tomas F et al. Influence of he art rate on mortality in a French populati on. Role of age, gender, and blo od pressure. Hypertensi on 1999; 33: 44– 52.
16. Morcet JF, Safar M, Thomas F et al. Associ ati on between he art rate and other risk factors in large French populati on. J Hypertenz 1999; 17: 1671– 1676.
17. Benetos A, Rudnichi A, Thomas F et al. HTA – fréquence cardi aque et risque cardi ovasculaire. Arch Mal Coe ur Vaiss 1993; (Suppl. 11): 1371– 1376.
18. Palatini P, Casigli a E, Juli us S et al. High he art rate. A risk factor for cardi ovascular de ath in elderly men. Arch Intern Med 1999; 159: 1404– 1410.
19. Palatini P, Thijs L, Staessen JA et al. Predictive value of clinic and ambulatory he art rate for mortality in elderly subjects with systolic hypertensi on. Arch Intern Med 2002; 162: 2313– 2321.
20. Kjekshus JK. Importance of he art rate in determining beta‑blocker efficacy in acute long‑term myocardi al interventi on tri als. Am J Cardi ol 1986; 57: 43F– 49F.
21. The Multicenter Dilti azem Postinfarcti on Tri al Rese arch Gro up. The effect of dilti azem on mortality and reinfarcti on after myocardi al infarcti on. N Engl J Med 1988; 319: 385– 392.
22. The Danish Study Gro up on Verapamil in Myocardi al Infarcti on. Effect of verapamil on mortality and major events after acute myocardi al infarcti on (The Danish Verapamil Infarcti on Tri al – DAVIT II). Am J Cardi ol 1990; 66: 779– 785.
23. Borer JS, Fox K, Jaillon P et al. Ivabradine Investigators Gro up. Anti anginal and antiischemic effects of ivabradine, an If inhibitor, in stable angina: a randomised, do uble- blind, multicentered, placebo- controlled tri al. Circulati on 2003; 107: 817– 823.
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Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2008 Issue 4
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