Heart rate distribution and predictors of increased heart rate among French hypertensive patients with stable coronary artery disease. Data from the LHYCORNE cohort.

Summary Background Heart rate is a key determinant of both myocardial ischaemia and prognosis in patients with coronary disease. Reducing heart rate is known to relieve ischaemia and improve cardiovascular prognosis. Currently there is no information about heart rate distribution and predictors of high heart rate in patients with stable coronary artery disease (CAD). Methods The L’Hypertendu Coronarien Vu En Medecine Generale (LHYCORNE) cohort was a prospective observational study involving consecutive stable CAD patients with treated hypertension. Patients with atrial fibrillation were excluded from the analysis. Heart rate distribution and factors independently associated with heart rate above that of the cohort mean were analysed. Results The study population comprised 8922 stable CAD patients in sinus rhythm (76% were men; mean age 66 ± 11 years; mean systolic/diastolic blood pressures 141/82 mmHg; 26% had diabetes). The mean resting heart rate was 70 ± 6 bpm; the distribution was: 7% for 60 bpm, 38% for 60–69, 38% for 70–79 bpm, 14% for 80–89 bpm, and 2% for > 90 bpm. The mean resting heart rate of the patients on beta-blockers (62% of the population) was 69 ± 8 bpm versus 73 ± 8 bpm in subjects not on beta-blockers ( p Conclusion Data from this large cohort demonstrate that few patients meet recommendations to lower heart rate to 60 bpm. Over 50% of stable CAD patients had a heart rate ≥ 70 bpm, presenting a particularly high-risk profile. Given the therapeutic and prognostic role of resting heart rate in CAD patients, our findings emphasize the need to consider heart rate in these high-risk patients.