Heart rate as a predictor of cardiovascular risk

Abstract

Background: Heart rate (HR) is a predictor of cardiovascular, cerebrovascular and all-cause mortality in the general population, as well as in patients with cardio- and cerebrovascular diseases. We aimed to summarize current knowledge regarding the influence of HR on cardio- and cerebrovascular morbidity and mortality.

Materials and methods: PubMed, MEDLINE, Ovid and EMBASE databases were searched for large follow-up studies or meta-analysis published between January 1990 and September 2017 in the English language using the following keyword "heart rate," "resting heart rate," "mortality," "outcome," "hypertension," "heart failure," "ischaemic heart disease," "coronary heart disease" and "stroke."

Results: The relationship between increased HR and cardio- and cerebrovascular morbidity and mortality has been reported in a large number of studies, and the results regarding this association are concurrent. This connection is generally stronger in men than in women. The increase in HR usually occurs in parallel with elevation of blood pressure and metabolic disturbances (insulin resistance, dyslipidaemia). However, even after adjustment for the most important cardiovascular risk factors, HR remained an independent predictor of adverse events in global population or in patients with cardio- and cerebrovascular diseases.

Conclusion: HR has an important negative effect on cardio- and cerebrovascular morbidity and mortality. Future longitudinal investigations should clarify HR significance and optimal HR reduction for primary and secondary prevention in cardio- and cerebrovascular events.

Keywords: heart failure; heart rate; hypertension; ischaemic heart disease; mortality; stroke.