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Tachycardia: The hidden cardiovascular risk factor in uncomplicated arterial hypertension

Katarzyna Cierpka-Kmieć, Dagmara Hering
DOI: 10.5603/CJ.a2019.0021
·
Pubmed: 30799548

open access

Ahead of print
Review articles
Published online: 2019-02-20

Abstract

Early detection and management of elevated blood pressure is crucial in reducing the burden of cardiovascular disease (CVD). The importance of an absolute risk assessment and patient risk stratification has been highlighted in the European hypertension guidelines since 2003. Amongst numerous risk factors influencing patient prognosis, elevated heart rate (HR) has been indicated as important predictor of future risk of hypertension, coronary heart disease, sudden cardiac death, heart failure, CVD, stroke, total cancer and mortality. Given that resting HR can be easily determined in clinical practice and modified by lifestyle changes as well as beta-blocker therapy, it seems reasonable that lowering resting HR should be a potential target to reduce disease burden and premature mortality. However, there is a lack of outcome studies of HR lowering in tachycardia-related hypertension. This review outlines the underlying mechanisms of early course hypertension pathophysiology with the critical role of the sympathetic nervous system activation, the prognostic significance of fast HR and the mechanistic rationale for the use of non-pharmacological approaches and/or highly long-acting cardioselective beta blockers with some consideration given to betaxolol properties.

Abstract

Early detection and management of elevated blood pressure is crucial in reducing the burden of cardiovascular disease (CVD). The importance of an absolute risk assessment and patient risk stratification has been highlighted in the European hypertension guidelines since 2003. Amongst numerous risk factors influencing patient prognosis, elevated heart rate (HR) has been indicated as important predictor of future risk of hypertension, coronary heart disease, sudden cardiac death, heart failure, CVD, stroke, total cancer and mortality. Given that resting HR can be easily determined in clinical practice and modified by lifestyle changes as well as beta-blocker therapy, it seems reasonable that lowering resting HR should be a potential target to reduce disease burden and premature mortality. However, there is a lack of outcome studies of HR lowering in tachycardia-related hypertension. This review outlines the underlying mechanisms of early course hypertension pathophysiology with the critical role of the sympathetic nervous system activation, the prognostic significance of fast HR and the mechanistic rationale for the use of non-pharmacological approaches and/or highly long-acting cardioselective beta blockers with some consideration given to betaxolol properties.

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Keywords

essential hypertension, tachycardia, cardiac output, peripheral resistance, muscle sympathetic nerve activity, non-pharmacological approaches, betaxolol

About this article
Title

Tachycardia: The hidden cardiovascular risk factor in uncomplicated arterial hypertension

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Review Article

Published online

2019-02-20

DOI

10.5603/CJ.a2019.0021

Pubmed

30799548

Keywords

essential hypertension
tachycardia
cardiac output
peripheral resistance
muscle sympathetic nerve activity
non-pharmacological approaches
betaxolol

Authors

Katarzyna Cierpka-Kmieć
Dagmara Hering

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