STATE-OF-THE-ART PAPER
Resting Heart Rate in Cardiovascular Disease
Kim Fox, MD, FESC*,*,
Jeffrey S. Borer, MD, FACC ,
A. John Camm, MD, FESC, FACC ,
Nicolas Danchin, MD, FESC ,
Roberto Ferrari, MD, FESC||,
Jose L. Lopez Sendon, MD, FESC, FACC¶,
Philippe Gabriel Steg, MD, FESC, FACC#,
Jean-Claude Tardif, MD, FACC, FRCPC**,
Luigi Tavazzi, MD, FESC, FACC,
Michal Tendera, MD, FESC, FACC for the Heart Rate Working Group
* Royal Brompton Hospital, London, England
Weill Medical College of Cornell University, New York, New York
Division of Cardiac and Vascular Sciences, St. George’s University of London, London, England
Hôpital Européen Georges Pompidou, Paris, France
|| Arcispedale S. Anna, Divisione di Cardiologia, University of Ferrara, Ferrara, Italy
¶ Hospital Universitario La Paz, Madrid, Spain
# Hôpital Bichat, Claude Bernard, Paris, France
** Montreal Heart Institute, Université de Montreal, Montreal, Canada
Department of Cardiology, Policlinico San Matteo, Institute of Care and Research, Pavia, Italy
Silesian School of Medicine, 3rd Division of Cardiology, Katowice, Poland.
Manuscript received December 21, 2006;
revised manuscript received March 27, 2007,
accepted April 10, 2007.
* Reprint requests and correspondence: Dr. Kim Fox, Royal Brompton Hospital, Sydney Street, London SW3 6NP, England. (Email: k.fox{at}rbh.nthames.nhs.uk).
The importance of resting heart rate (HR) as a prognostic factor and potential therapeutic target is not yet generally accepted. Recent large epidemiologic studies have confirmed earlier studies that showed resting HR to be an independent predictor of cardiovascular and all-cause mortality in men and women with and without diagnosed cardiovascular disease. Clinical trial data suggest that HR reduction itself is an important mechanism of benefit of beta-blockers and other heart-rate lowering drugs used after acute myocardial infarction, in chronic heart failure, and in stable angina pectoris. Pathophysiological studies indicate that a relatively high HR has direct detrimental effects on the progression of coronary atherosclerosis, on the occurrence of myocardial ischemia and ventricular arrhythmias, and on left ventricular function. Studies have found a continuous increase in risk with HR above 60 beats/min. Although it may be difficult to define an optimal HR for a given individual, it seems desirable to maintain resting HR substantially below the traditionally defined tachycardia threshold of 90 or 100 beats/min. These findings suggest that the potential role of HR and its modulation should be considered in future cardiovascular guidance documents.
|
Abbreviations and Acronyms
| | AMI = acute myocardial infarction | | HR = heart rate |
|
This article has been cited by other articles:
|
|
|
|
 
L. P. Christensen, R.-l. Zhang, W. Zheng, J. J. Campanelli, E. I. Dedkov, R. M. Weiss, and R. J. Tomanek
Postmyocardial infarction remodeling and coronary reserve: effects of ivabradine and beta blockade therapy
Am J Physiol Heart Circ Physiol,
July 1, 2009;
297(1):
H322 - H330.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Ceconi, A. Cargnoni, G. Francolini, G. Parinello, and R. Ferrari
Heart rate reduction with ivabradine improves energy metabolism and mechanical function of isolated ischaemic rabbit heart
Cardiovasc Res,
June 11, 2009;
(2009)
cvp158v2.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Bohm, M. Thoenes, H.-R. Neuberger, S. Graber, J.-C. Reil, P. Bramlage, and M. Volpe
Atrial fibrillation and heart rate independently correlate to microalbuminuria in hypertensive patients
Eur. Heart J.,
June 1, 2009;
30(11):
1364 - 1371.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-C. Tardif
Heart rate as a treatable cardiovascular risk factor
Br. Med. Bull.,
June 1, 2009;
90(1):
71 - 84.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Mukaddam-Daher, A. Menaouar, P.-A. Paquette, M. Jankowski, J. Gutkowska, M.-A. Gillis, Y.-F. Shi, A. Calderone, and J.-C. Tardif
Hemodynamic and Cardiac Effects of Chronic Eprosartan and Moxonidine Therapy in Stroke-Prone Spontaneously Hypertensive Rats
Hypertension,
May 1, 2009;
53(5):
775 - 781.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Beddhu, S. U. Nigwekar, X. Ma, and T. Greene
Associations of resting heart rate with insulin resistance, cardiovascular events and mortality in chronic kidney disease
Nephrol. Dial. Transplant.,
March 22, 2009;
(2009)
gfp057v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-C. Tardif, P. Ponikowski, T. Kahan, and for the ASSOCIATE study Investigators
Efficacy of the If current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial
Eur. Heart J.,
March 1, 2009;
30(5):
540 - 548.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Logeart, J.-P. Gueffet, F. Rouzet, F. Pousset, C. Chavelas, A. C. Solal, and G. Jondeau
Heart rate per se impacts cardiac function in patients with systolic heart failure and pacing: a pilot study
Eur J Heart Fail,
January 1, 2009;
11(1):
53 - 57.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Gopinathannair, R. M. Sullivan, and B. Olshansky
Slower Heart Rates for Healthy Hearts: Time to Redefine Tachycardia?
Circ Arrhythmia Electrophysiol,
December 1, 2008;
1(5):
321 - 323.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Olshansky, U. Ebinger, J. Brum, M. Egermark, A. Viegas, and L. Rekeda
Differential Pharmacological Effects of Antimuscarinic Drugs on Heart Rate: A Randomized, Placebo-controlled, Double-blind, Crossover Study With Tolterodine and Darifenacin in Healthy Participants >=50 Years
Journal of Cardiovascular Pharmacology and Therapeutics,
December 1, 2008;
13(4):
241 - 251.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Tverdal, V. Hjellvik, and R. Selmer
Heart rate and mortality from cardiovascular causes: a 12 year follow-up study of 379 843 men and women aged 40-45 years
Eur. Heart J.,
November 2, 2008;
29(22):
2772 - 2781.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Escobar and V. Barrios
High resting heart rate: a cardiovascular risk factor or a marker of risk?
Eur. Heart J.,
November 2, 2008;
29(22):
2823 - 2824.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Nagele, W. Rodiger, and M. A. Castel
Rate-responsive pacing in patients with heart failure: long-term results of a randomized study
Europace,
October 1, 2008;
10(10):
1182 - 1188.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Goldberger, M. E. Cain, S. H. Hohnloser, A. H. Kadish, B. P. Knight, M. S. Lauer, B. J. Maron, R. L. Page, R. S. Passman, D. Siscovick, et al.
American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention
J. Am. Coll. Cardiol.,
September 30, 2008;
52(14):
1179 - 1199.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Goldberger, M. E. Cain, S. H. Hohnloser, A. H. Kadish, B. P. Knight, M. S. Lauer, B. J. Maron, R. L. Page, R. S. Passman, D. Siscovick, et al.
American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention
Circulation,
September 30, 2008;
118(14):
1497 - 1518.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Carney, B. Steinmeyer, K. E. Freedland, J. A. Blumenthal, P. K. Stein, W. A. Steinhoff, W. B. Howells, L. F. Berkman, L. L. Watkins, S. M. Czajkowski, et al.
Nighttime Heart Rate and Survival in Depressed Patients Post Acute Myocardial Infarction
Psychosom Med,
September 1, 2008;
70(7):
757 - 763.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Olshansky, H. N. Sabbah, P. J. Hauptman, and W. S. Colucci
Parasympathetic Nervous System and Heart Failure: Pathophysiology and Potential Implications for Therapy
Circulation,
August 19, 2008;
118(8):
863 - 871.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Ferrari, C. Ceconi, and G. Guardigli
Pathophysiological role of heart rate: from ischaemia to left ventricular dysfunction
Eur. Heart J. Suppl.,
August 1, 2008;
10(suppl_F):
F7 - F10.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Zamorano
Heart rate management: a therapeutic goal throughout the cardiovascular continuum
Eur. Heart J. Suppl.,
August 1, 2008;
10(suppl_F):
F17 - F21.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. K. Lahiri, P. J. Kannankeril, and J. J. Goldberger
Assessment of Autonomic Function in Cardiovascular Disease: Physiological Basis and Prognostic Implications
J. Am. Coll. Cardiol.,
May 6, 2008;
51(18):
1725 - 1733.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Spaak, A. C. Merlocco, G. J. Soleas, G. Tomlinson, B. L. Morris, P. Picton, C. F. Notarius, C. T. Chan, and J. S. Floras
Dose-related effects of red wine and alcohol on hemodynamics, sympathetic nerve activity, and arterial diameter
Am J Physiol Heart Circ Physiol,
February 1, 2008;
294(2):
H605 - H612.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Fox, J. S. Borer, A. J. Camm, N. Danchin, R. Ferrari, J. L. Lopez Sendon, P. G. Steg, J.-C. Tardif, L. Tavazzi, M. Tendera, et al.
Reply
J. Am. Coll. Cardiol.,
January 22, 2008;
51(3):
331 - 332.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. H. Messerli and S. Bangalore
Resting Heart Rate and Cardiovascular Disease: The Beta-Blocker Hypertension Paradox
J. Am. Coll. Cardiol.,
January 22, 2008;
51(3):
330 - 331.
[Full Text]
[PDF]
|
|
|
|
