Document Detail

Inadequate control of heart rate in patients with stable angina: results from the European heart survey.
MedLine Citation:
PMID:  20354044     Owner:  NLM     Status:  MEDLINE    
AIMS: To examine resting heart rate (HR) in a population presenting with stable angina in relation to prior and subsequent pharmacological treatment, comorbid conditions and clinical outcome. METHODS AND RESULTS: The European Heart Survey was a prospective, observational, cohort study of 3779 patients with stable angina newly presenting to cardiology services. Mean baseline resting HR was 73 beats/min (bpm) and 52.3% of patients had a baseline HR > 70 bpm. Over half of patients were on no chronotropic medication at baseline. Patients with chronic respiratory disease or diabetes had higher resting HRs (75-76 bpm), and were more likely to have been receiving calcium channel blockers at baseline assessment. Overall, beta-blockers were the most common treatment administered following cardiologist assessment, but were used less frequently in patients with chronic respiratory disease and diabetes, and the dosages used were less than that found to be effective in clinical trials. Mean daily doses of metoprolol, bisoprolol, carvedilol, and atenolol were 75 mg, 6 mg, 19 mg and 55 mg, respectively. Higher HR at baseline was associated with higher rates of cardiovascular mortality and hospitalisation for heart failure. CONCLUSION: Control of ischaemic symptoms through heart rate modification in patients with angina is currently inadequate, both by primary referring physicians and cardiologists. Given the adverse outcome associated with higher resting heart rates in this as in other studies, and the availability of specific HR reducing strategies, attention should be given to achieving optimal HR control.
Caroline A Daly; Felicity Clemens; Jose L Lopez Sendon; Luigi Tavazzi; Eric Boersma; Nicolas Danchin; François Delahaye; Anselm Gitt; Desmond Julian; David Mulcahy; Witold Ruzyllo; Kristian Thygesen; Freek Verheugt; Kim M Fox;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  86     ISSN:  1469-0756     ISO Abbreviation:  Postgrad Med J     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-31     Completed Date:  2010-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  212-7     Citation Subset:  IM    
St James's Hospital, Dublin 8, Ireland.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angina Pectoris / complications,  drug therapy,  physiopathology*
Anti-Arrhythmia Agents / therapeutic use*
Arrhythmias, Cardiac / complications,  drug therapy*
Diabetes Complications / complications
Heart Rate* / physiology
Hypertension / complications
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive / complications
Risk Factors
Vascular Diseases / complications
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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