ABSTRACT
In hypertension (HTN), the cardiovascular risk related to tachycardia seems to depend mainly on the clustering of several risk factors due to an underlying dysfunction of the autonomic nervous system. This chapter focuses on the relationship between high heart rate and these risk factors, and the mechanisms for the connection between tachycardia, HTN, obesity, metabolic syndrome and cardiovascular risk. Blood pressure, plasma glucose, lipids and fasting insulin proved to be much higher in the subjects with high heart rate than in those with normal heart rate, especially in men. Some authors even claimed that pharmacological heart rate lowering can have a detrimental effect in HTN. In age- and sex-adjusted models, both office and ambulatory heart rates were significant predictors of outcome. However, in a multivariable model that included all major cardiovascular risk factors, only ambulatory heart rate remained independently associated with cardiovascular events.
