Curr Hypertens Rev. 2026 Mar 24. doi: 10.2174/0115734021424078251219091427. Online ahead of print.
ABSTRACT
It is widely recognized that not only high blood pressure (BP) but also increased resting heart rate (RHR) impairs prognosis in patients with arterial hypertension (HTN). This study aims to answer 5 questions regarding the guidelines on HTN: 1. 'Is the significance of high RHR in HTN acknowledged?'; 2. 'Is there a recommendation to decrease RHR in chronic antihypertensive treatment?'; 3. 'Which antihypertensive medication is preferred to diminish high RHR in HTN patients?' 4. 'What is the treatment threshold value of RHR in patients with HTN?' and 5. 'Is there a recommendation for target RHR in chronic treatment of HTN?'. The significance of RHR and the treatment approach to it are scarcely mentioned in the key publi-cations-the guidelines on HTN-and there is no obvious firm argument to omit recommen-dations related to threshold and target RHR in HTN patients. On the contrary, there are at least five (major) reasons for addressing increased RHR in HTN guidelines. The vast majority of HTN guidelines do not acknowledge the significance of RHR elevation (as a cardiovascular risk factor). This discrepancy affects as much as 30-38% of the hypertensive population (that is, global > 1.28 billion adults - according to the World Health Organization). We highlight the need for improvement in the forthcoming guidelines that (in the current versions) do not explain the importance of RHR in HTN. Additional investigations are needed to confirm whether reducing high resting heart rate in HTN patients improves prognosis.
PMID:41879456 | DOI:10.2174/0115734021424078251219091427