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J Hypertens. 2016 May;34(5):813-21. doi: 10.1097/HJH.0000000000000865.

Management of the hypertensive patient with elevated heart rate: Statement of the Second Consensus Conference endorsed by the European Society of Hypertension.

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aDepartment of Medicine, University of Padova, Padua bDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy cThe George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia dDepartment of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM, Ferrara eClinica Medica, Dipartimento di Scienze della Salute, Universita'Milano-Bicocca and IRCCS Multimedica, Sesto San Giovanni, Milan, Italy fDepartment of Cardiovascular Medicine, Dokkyo Medical University, Okinawa, Japan gUniversity Hospital Center Zagreb, Zagreb, Croatia hDepartment of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark iDivision of Hypertension, University of Michigan, Ann Arbor, Michigan, USA jDepartment of Cardiology, Ullevaal University Hospital, Oslo, Norway kUniversity of Milano-Bicocca and IRCCS Istituto Auxologico Italiano, Milan lDepartment of Medicine, University of Padova, Italy and Medicina Interna Î, Ca' Foncello Hospital, Treviso oClinica Nefrologica, Ospedale San Gerardo, Monza pCentro Interuniversitario di Fisiologia Clinica e Ipertensione, University of Milan, and Istituto Auxologico Italiano, Milan, Italy.


In June 2015, a panel of experts gathered in a consensus conference to plan updating recommendations on the management of the hypertensive patient with elevated heart rate (HR), previously released in 2006. The issues examined during that meeting and further discussed by the participants during the following months involved the assessment of HR, the relevance of HR as a cardiovascular risk factor, the definition of tachycardia and the treatment of the hypertensive patient with high HR. For the measurement of resting HR the panel experts recommended that scientific investigations focusing on HR should report information on length of resting period before measurement, information about temperature and environment, method of measurement, duration of measurement, number of readings, time interval between measurements, body position and type of observer. According to the panellists there is convincing evidence that HR is an important risk factor for cardiovascular disease and they suggest to routinely include HR measurement in the assessment of the hypertensive patient. Regarding the definition of tachycardia, the panellists acknowledged that in the absence of convincing data any threshold used to define tachycardia is arbitrary. Similarly, as there are no outcome studies of HR lowering in tachycardia hypertension, the panellists could not make practical therapeutic suggestions for the management of such patients. However, the experts remarked that absence of evidence does not mean evidence against the importance of tachycardia as a risk factor for cardiovascular disease and that long-term exposure to a potentially important risk factor may impair the patient's prognosis. The main aims of the present document are to alert researchers and physicians about the importance of measuring HR in hypertensive patients, and to stimulate research to clarify unresolved issues.

[Indexed for MEDLINE]

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