Heart rate as a risk factor in hypertensive individuals. The Italian TensioPulse Study

Background and Aim: The predictive role of heart rate as a new, independent risk factor for the development of high blood pressure and cardiovascular diseases (CVD) has been investigated in recent years and many studies have demonstrated a significant and independent association between heart rate, blood pressure and cardiovascular (CV) endpoints. Various pathogenic pathways can be postulated to explain this association and the role of heart rate as a plausible risk factor. Previous studies have been limited to the examination of small samples of general populations. By contrast, our study is based on a large cohort (38,145) of hypertensive patients. Methods and Results: The Italian TensioPulse Study is a detailed investigation of the relation between heart rate (HR) and other CV risk factors in a large cohort of hypertensives. A strong, positive relationship was found between heart rate and both systolic and diastolic blood pressure: r=0.21 for SBP in both sexes, and r=0.21 and r=0.24 for DBP in men and women respectively. Smoking and drinking habits seem to be associated with higher heart rate, SBP and DBP values. Conclusions: These findings and the observation that more than one out of three hypertensives had a relatively high heart rate could assist in the organisation of prevention programmes. Correction of certain lifestyle factors must precede the decision to use drugs to reduce the global CVD risk.