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Editorials

Slower Heart Rates for Healthy Hearts

Time to Redefine Tachycardia?

Rakesh Gopinathannair, MD, MA; Renee M. Sullivan, MD and Brian Olshansky, MD

From the Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Correspondence to Brian Olshansky, MD, Professor of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, 4426a JCP, Iowa City, IA 52242. E-mail brian-olshansky@uiowa.edu

Key Words: atrium • fibrillation • heart rate • hypertension • hypertrophy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The management of atrial fibrillation, even in the modern era, remains complex and challenging. Preventing atrial fibrillation occurrence by identifying and favorably improving modifiable risk factors thus assumes great importance. It is well known that hypertension and resultant structural heart disease contributes significantly to the incidence of atrial fibrillation.^1,2 The Losartan Intervention For End point reduction in hypertension (LIFE) study thus far has shown us that angiotensin-receptor blockade and reduction in left ventricular hypertrophy, irrespective of blood pressure–lowering, reduces the incidence of new-onset atrial fibrillation.^1,3

Article see p 337

In recent years, accumulating evidence has linked high resting sinus heart rates (HR) directly and indirectly to adverse cardiovascular outcomes.^4,5 Epidemiological studies show resting HR to be an independent predictor of cardiovascular and all-cause mortality in general population as well as in hypertensive patients.⁶ The cardiovascular benefits offered by β-blockade in coronary artery disease and heart failure have, in part, been attributed to β-blocker–mediated HR reduction.^7,8 Other studies have linked high baseline HR to the development of hypertension, to the progression of coronary artery disease, and to the triggering of myocardial infarction, ventricular dysfunction, and ventricular arrhythmias.^6,9–11 In this issue of Circulation: Arrhythmia and Electrophysiology, Okin and colleagues¹² examines the relationship of HR changes over time on risk of atrial fibrillation in hypertensive patients as part of the LIFE study.

In this post hoc analysis of the prospective LIFE study, 8828 hypertensive patients with left ventricular hypertrophy by ECG but without a history of atrial fibrillation were followed for a . . . [Full Text of this Article]

Related Article

Incidence of Atrial Fibrillation in Relation to Changing Heart Rate Over Time in Hypertensive Patients: The LIFE Study

Peter M. Okin, Kristian Wachtell, Sverre E. Kjeldsen, Stevo Julius, Lars H. Lindholm, Björn Dahlöf, Darcy A. Hille, Markku S. Nieminen, Jonathan M. Edelman, and Richard B. Devereux
Circ Arrhythm Electrophysiol 2008 1: 337-343. [Abstract] [Full Text] [PDF]