Heart rate and cardiovascular protection

Eur J Intern Med. 2015 May;26(4):217-22. doi: 10.1016/j.ejim.2015.02.009. Epub 2015 Feb 20.


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.

Keywords: Atherosclerosis; Autonomic dysfunction; Cardiovascular risk factors; Endothelial dysfunction; Heart rate variability; Resting heart rate.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Arrhythmias, Cardiac / physiopathology*
  • Atherosclerosis / drug therapy
  • Benzazepines / therapeutic use*
  • Cardiovascular Agents / therapeutic use*
  • Clinical Trials as Topic
  • Heart Failure / drug therapy
  • Heart Rate*
  • Humans
  • Hypertension / drug therapy
  • Ivabradine
  • Myocardial Ischemia / physiopathology*
  • Risk Factors


  • Adrenergic beta-Antagonists
  • Benzazepines
  • Cardiovascular Agents
  • Ivabradine