Resting heart rate: a modifiable prognostic indicator of cardiovascular risk and outcomes?
A growing body of evidence from clinical trials and epidemiological studies has identified elevated resting heart rate as a predictor of clinical events. Proof of direct cause and effect is limited, because current drugs that lower heart rate (eg, beta-blockers) have multiple mechanisms of action. A new class of drug, selective I(f) inhibitors, is under investigation as a 'pure' heart rate-reducing medication and will help confirm if there is a causal link between elevated heart rate and cardiovascular outcomes. The present paper reviews the evidence for elevated heart rate as a cardiovascular risk factor and some of the current clinical trials testing this hypothesis.
Arnold
J Malcolm
JM
University of Western Ontario, London, Canada. malcolm.arnold@hsc.on.ca
Fitchett
David H
DH
Howlett
Jonathan G
JG
Lonn
Eva M
EM
Tardif
Jean-Claude
JC
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D002986:Clinical Trials as Topic; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D011379:Prognosis; D012146:Rest / Q000502:physiology*; D018570:Risk Assessment; D012307:Risk Factors