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J Cardiol. 2013 Sep;62(3):183-7. doi: 10.1016/j.jjcc.2013.02.018. Epub 2013 Jun 24.

Heart rate: a global target for cardiovascular disease and therapy along the cardiovascular disease continuum.

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Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, 66421 Homburg, Saar, Germany. Electronic address:


Heart rate is a predictor of cardiovascular and all-cause mortality in the general population and in patients with cardiovascular disease. Increased resting heart rate multiplies risk and interferes at all stages of the cardiovascular disease continuum initiating from endothelial dysfunction and continuing via atherosclerotic lesion formation and plaque rupture to end-stage cardiovascular disease. As a therapeutic target, heart rate is accessible via numerous pharmacological interventions. The concept of selective heart rate reduction by the I(f) current inhibitor ivabradine provides an option to intervene effectively along the chain of events and to define the specific and prognostic role of heart rate for patients with coronary artery disease and heart failure. Future interventional studies will further clarify the significance of heart rate and targeted heart rate reduction for primary and secondary prevention in cardiovascular and cerebrovascular events.


Cardiovascular disease continuum; Heart rate; I(f) current inhibition; Risk reduction

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