Usefulness of heart rate to predict cardiac events in treated patients with high-risk systemic hypertension

Stevo Julius, Paolo Palatini, Sverre E. Kjeldsen, Alberto Zanchetti, Michael A. Weber, Gordon T. McInnes, Hans R. Brunner, Giuseppe Mancia, M. Anthony Schork, Tsushung A. Hua, Bjoern Holzhauer, Dion Zappe, Silja Majahalme, Kenneth Jamerson, Nevres Koylan

Research output: Contribution to journalArticlepeer-review


A high heart rate (HR) predicts future cardiovascular events. We explored the predictive value of HR in patients with high-risk hypertension and examined whether blood pressure reduction modifies this association. The participants were 15,193 patients with hypertension enrolled in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial and followed up for 5 years. The HR was assessed from electrocardiographic recordings obtained annually throughout the study period. The primary end point was the interval to cardiac events. After adjustment for confounders, the hazard ratio of the composite cardiac primary end point for a 10-beats/min of the baseline HR increment was 1.16 (95% confidence interval 1.12 to 1.20). Compared to the lowest HR quintile, the adjusted hazard ratio in the highest quintile was 1.73 (95% confidence interval 1.46 to 2.04). Compared to the pooled lower quintiles of baseline HR, the annual incidence of primary end point in the top baseline quintile was greater in each of the 5 study years (all p

Original languageEnglish
Pages (from-to)685-692
Number of pages8
JournalThe American Journal of Cardiology
Issue number5
Publication statusPublished - Mar 1 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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