Fast Heart Rate Predictive of Cardiac Events in High-Risk HTN

Elevated heart rate in patients with high-risk hypertension is warning signal for cardiac event

TUESDAY, Feb. 28 (HealthDay News) -- A fast heart rate is a strong predictor of adverse cardiac events in patients with high-risk hypertension, according to a study published in the March 1 issue of The American Journal of Cardiology.

Stevo Julius, M.D., Sc.D., of the University of Michigan in Ann Arbor, and associates investigated the predictive value of heart rate for future cardiovascular events in patients with high-risk hypertension, using electrocardiographic recordings from 15,193 patients enrolled in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. The interval to cardiac events was the primary end point.

The researchers found that, after adjusting for confounders, a 10-beats/minute increase of the baseline heart rate increment was associated with a significant increase in the primary end point (hazard ratio [HR], 1.16). The adjusted HR for the highest versus the lowest quintile of heart rate was 1.73. Compared to the pooled lower quintiles of baseline heart rate, in each of the five study years, the annual incidence of the primary end point was significantly higher in the highest baseline quintile. The incidence of end points in the top quintile versus the other four quintiles was 53 percent greater in patients with well-controlled blood pressure (P = 0.001) and 34 percent greater in those with uncontrolled blood pressure (P = 0.002).

"In most diseases of civilization (e.g., dyslipidemia, diabetes, and hypertension) treating the marker (lipids, blood glucose, and blood pressure) is associated with a significant decrease in cardiovascular events. This might also be true for heart rate," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which funded the VALUE study.

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