Journal
EUROPEAN JOURNAL OF INTERNAL MEDICINE
Volume 26, Issue 4, Pages 217-222Publisher
ELSEVIER
DOI: 10.1016/j.ejim.2015.02.009
Keywords
Resting heart rate; Heart rate variability; Cardiovascular risk factors; Endothelial dysfunction; Atherosclerosis; Autonomic dysfunction
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Recent large epidemiological studies have confirmed that an elevated resting heart rate is an independent predictor of cardiovascular and overall mortality in the general population as well as in patients with hypertension, coronary heart disease and chronic heart failure. Pathophysiological studies indicate that a higher heart rate has detrimental effects that favor myocardial ischemia, ventricular arrhythmias, as well as an increase in vascular oxidative stress, endothelial dysfunction and atherosclerosis progression. Benefits of heart rate lowering drugs, such as beta-blockers and ivabradine, in reducing overall and cardiovascular-related mortality, have been demonstrated particularly in patients with coronary heart disease and heart failure. However, despite these evidences, resting heart rate is still an overlooked cardiovascular risk factor. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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