Heart Rate as an Independent Risk Factor for Cardiovascular Disease

Mounting evidence shows that elevated heart rate (>80–85 beats/min) measured under resting conditions is directly associated with risk of developing hypertension and atherosclerosis, and is a potent predictor of cardiovascular morbidity and mortality. Several epidemiological studies have shown that these relationships are independent of other risk factors for atherosclerosis, and are present in individuals free of disease as well as in patients with cardiovascular disease. Experimental and clinical studies suggest that the haemodynamic disturbances related to elevated heart rate have a direct impact on the arterial wall, promoting the development of atherosclerotic plaques. In addition, heart rate has been directly related to the development of cardiovascular events associated with plaque disruption, which is statistically more likely as heart rate increases. In light of this evidence, heart rate should be included among the major risk factors for coronary heart disease.

[1]  R. Levy,et al.  Transient tachycardia; prognostic significance alone and in association with transient hypertension. , 1945, The Medical press of Egypt.

[2]  H A Lindberg,et al.  Heart rate as a prognostic factor for coronary heart disease and mortality: findings in three Chicago epidemiologic studies. , 1980, American journal of epidemiology.

[3]  C. Zarins,et al.  Retarding effect of lowered heart rate on coronary atherosclerosis. , 1984, Science.

[4]  S. Manuck,et al.  Inhibition of coronary atherosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. , 1987, Circulation.

[5]  R S Paffenbarger,et al.  Heart rate and cardiovascular mortality: the Framingham Study. , 1987, American heart journal.

[6]  J Ross,et al.  Influence of heart rate on mortality after acute myocardial infarction. , 1990, The American journal of cardiology.

[7]  J. Feldman,et al.  Pulse rate, coronary heart disease, and death: the NHANES I Epidemiologic Follow-up Study. , 1991, American heart journal.

[8]  P Ducimetière,et al.  Prognostic significance of exercise blood pressure and heart rate in middle-aged men. , 1992, Hypertension.

[9]  A. Hamsten,et al.  Minimum heart rate and coronary atherosclerosis: independent relations to global severity and rate of progression of angiographic lesions in men with myocardial infarction at a young age. , 1992, American heart journal.

[10]  R B D'Agostino,et al.  Influence of heart rate on mortality among persons with hypertension: the Framingham Study. , 1993, American heart journal.

[11]  S Glagov,et al.  Hemodynamic stress and experimental aortoiliac atherosclerosis. , 1994, Journal of vascular surgery.

[12]  Exercise haemodynamics in the normotensive and the hypertensive subject. , 1994, Clinical science.

[13]  J Col,et al.  Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction. Results from an international trial of 41,021 patients. GUSTO-I Investigators. , 1995, Circulation.

[14]  U. Goldbourt,et al.  The predictive value of admission heart rate on mortality in patients with acute myocardial infarction. SPRINT Study Group. Secondary Prevention Reinfarction Israeli Nifedipine Trial. , 1995, Journal of clinical epidemiology.

[15]  Predictive power of increased heart rate versus depressed left ventricular ejection fraction and heart rate variability for risk stratification after myocardial infarction. Results of a two-year follow-up study. , 1996, Journal of the American College of Cardiology.

[16]  W. Aronow,et al.  Association of average heart rate on 24-hour ambulatory electrocardiograms with incidence of new coronary events at 48-month follow-up in 1,311 patients (mean age 81 years) with heart disease and sinus rhythm. , 1996, The American journal of cardiology.

[17]  G. Mancia,et al.  Heart rate-dependence of arterial distensibility in vivo , 1996, Journal of hypertension.

[18]  S. Julius,et al.  Heart rate and the cardiovascular risk , 1997, Journal of hypertension.

[19]  G. Mancia,et al.  Effect of sympathectomy on mechanical properties of common carotid and femoral arteries. , 1997, Hypertension.

[20]  P. Palatini.  Heart rate as a cardiovascular risk factor , 1999 .

[21]  H V Huikuri,et al.  Heart rate variability and progression of coronary atherosclerosis. , 1999, Arteriosclerosis, thrombosis, and vascular biology.

[22]  E Casiglia,et al.  High heart rate: a risk factor for cardiovascular death in elderly men. , 1999, Archives of internal medicine.

[23]  L Guize,et al.  Influence of heart rate on mortality in a French population: role of age, gender, and blood pressure. , 1999, Hypertension.

[24]  P. Palatini,et al.  Reproducibility of heart rate measured in the clinic and with 24-hour intermittent recorders. , 1999, American journal of hypertension.

[25]  A. Reunanen,et al.  Heart rate and mortality , 2000, Journal of internal medicine.

[26]  E Geraci,et al.  Assessment of absolute risk of death after myocardial infarction by use of multiple-risk-factor assessment equations: GISSI-Prevenzione mortality risk chart. , 2001, European heart journal.

[27]  U. Heidland,et al.  Left Ventricular Muscle Mass and Elevated Heart Rate Are Associated With Coronary Plaque Disruption , 2001, Circulation.

[28]  E. Feskens,et al.  Cardiovascular risk factors and 10-year all-cause mortality in elderly European male populations. The FINE study , 2001 .

[29]  P. Palatini.  Heart rate as a cardiovascular risk factor: do women differ from men? , 2001, Annals of medicine.

[30]  Paolo Palatini,et al.  Heart rate during myocardial infarction: relationship with one-year global mortality in men and women. , 2002, The Canadian journal of cardiology.

[31]  C. Bulpitt,et al.  Predictive value of clinic and ambulatory heart rate for mortality in elderly subjects with systolic hypertension. , 2002, Archives of internal medicine.

[32]  J. Stessman,et al.  Sex Differences in the Effect of Heart Rate on Mortality in the Elderly , 2003, Journal of the American Geriatrics Society.

[33]  M. Safar,et al.  Effect of Chronic Heart Rate Reduction with Ivabradine on Carotid and Aortic Structure and Function in Normotensive and Hypertensive Rats , 2003, Journal of Vascular Research.

[34]  Jørgen K. Kanters,et al.  Heart Rate Versus Heart Rate Variability in Risk Prediction after Myocardial Infarction , 2003, Journal of cardiovascular electrophysiology.

[35]  Yutaka Imai,et al.  Prognostic value of home heart rate for cardiovascular mortality in the general population: the Ohasama study. , 2004, American journal of hypertension.

[36]  Roberto Sega,et al.  Prognostic Value of Ambulatory and Home Blood Pressures Compared With Office Blood Pressure in the General Population: Follow-Up Results From the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) Study , 2005, Circulation.

[37]  Jean-Claude Tardif,et al.  Long-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease. , 2005, European heart journal.

[38]  Ian G. Harnik.  Heart-rate profile during exercise as a predictor of sudden death. , 2005, The New England journal of medicine.

[39]  Rainer Rauramaa,et al.  Heart rate response during exercise test and cardiovascular mortality in middle-aged men. , 2006, European heart journal.

[40]  Giuseppe Mancia,et al.  Identification and management of the hypertensive patient with elevated heart rate: statement of a European Society of Hypertension Consensus Meeting. , 2006, Journal of hypertension.

[41]  Shah Ebrahim,et al.  European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invit , 2007, European heart journal.

[42]  Shah Ebrahim,et al.  European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012) , 2012, International Journal of Behavioral Medicine.