Epidemiological studies have shown that chronically elevated resting heart rate (HR) is significantly associated with organ damage, morbidity and mortality in a wide range of patients including hypertensive patients. Evidence is also available that an increased HR reflects sympathetic nervous system overdrive which is also known to adversely affect organ structure and function and to increase the risk of unfavourable outcomes in several diseases. The causal relationship between elevated HR, organ damage, and cardiovascular outcomes can thus be explained by its relationship with sympathetic cardiovascular influences although evidence of sympathetically-independent adverse effect of HR increases per se makes it more complex. Interventions that target HR by modulating the sympathetic nervous system have therefore a strong pathophysiological and clinical rationale. As most clinical guidelines now recommend the use of combination therapies in patients with hypertension, it might be desirable to consider as combination components drugs which lower HR, if HR is elevated such as, according to guideliines, when it is above 80 b/min.

Mancia, G., Masi, S., Palatini, P., Tsioufis, C., Grassi, G. (2021). Elevated heart rate and cardiovascular risk in hypertension. JOURNAL OF HYPERTENSION, 39(6), 1060-1069 [10.1097/HJH.0000000000002760].

Elevated heart rate and cardiovascular risk in hypertension

Mancia, Giuseppe
Primo
;
Grassi, Guido
Ultimo
2021

Abstract

Epidemiological studies have shown that chronically elevated resting heart rate (HR) is significantly associated with organ damage, morbidity and mortality in a wide range of patients including hypertensive patients. Evidence is also available that an increased HR reflects sympathetic nervous system overdrive which is also known to adversely affect organ structure and function and to increase the risk of unfavourable outcomes in several diseases. The causal relationship between elevated HR, organ damage, and cardiovascular outcomes can thus be explained by its relationship with sympathetic cardiovascular influences although evidence of sympathetically-independent adverse effect of HR increases per se makes it more complex. Interventions that target HR by modulating the sympathetic nervous system have therefore a strong pathophysiological and clinical rationale. As most clinical guidelines now recommend the use of combination therapies in patients with hypertension, it might be desirable to consider as combination components drugs which lower HR, if HR is elevated such as, according to guideliines, when it is above 80 b/min.
Articolo in rivista - Articolo scientifico
beta-blockers, guidelines, hypertension, outcomes, resting heart rate, sympathetic nervous system;
English
2021
39
6
1060
1069
none
Mancia, G., Masi, S., Palatini, P., Tsioufis, C., Grassi, G. (2021). Elevated heart rate and cardiovascular risk in hypertension. JOURNAL OF HYPERTENSION, 39(6), 1060-1069 [10.1097/HJH.0000000000002760].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/314957
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