Resting heart rate: risk indicator and emerging risk factor in cardiovascular disease

Am J Med. 2015 Mar;128(3):219-28. doi: 10.1016/j.amjmed.2014.09.016. Epub 2014 Oct 15.


Resting heart rate is central to cardiac output and is influenced by changes occurring in numerous diseases. It predicts longevity and cardiovascular diseases, and current evidence suggests that it is also an important marker of outcome in cardiovascular disease, including heart failure. Beta-blockers improve outcomes in heart failure; however, they have effects outside reducing heart rate. Ivabradine has demonstrated efficacy in reducing rehospitalizations and mortality in heart failure and in improving exercise tolerance and reducing angina attacks in patients with coronary artery disease, whereas selective heart rate reduction may also prove to be beneficial in therapeutic areas outside those in which ivabradine has already demonstrated clinical efficacy. This review provides an update on the associations between heart rate and cardiovascular outcomes in various conditions, the experimental effects of heart rate reduction with ivabradine, and the potential new indications in cardiovascular disease.

Keywords: Angina; Heart failure; Heart rate; Ivabradine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Benzazepines / pharmacology*
  • Cardiovascular Agents / pharmacology
  • Cardiovascular Diseases* / physiopathology
  • Cardiovascular Diseases* / prevention & control
  • Heart Rate* / drug effects
  • Heart Rate* / physiology
  • Humans
  • Ivabradine
  • Rest / physiology*
  • Risk Factors
  • Treatment Outcome


  • Benzazepines
  • Cardiovascular Agents
  • Ivabradine