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Heart rate and blood pressure monitoring in heart failure
It has been long known that incessant tachycardia and severe hypertension can cause heart failure (HF). In recent years, it has also been recognized that more modest elevations in either heart rate (HR) or blood pressure (BP), if sustained, can be a risk factor both for the development of HF and for...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937500/ https://www.ncbi.nlm.nih.gov/pubmed/31908609 http://dx.doi.org/10.1093/eurheartj/suz217 |
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author | Ponikowski, Piotr Spoletini, Ilaria Coats, Andrew J S Piepoli, Massimo F Rosano, Giuseppe M C |
author_facet | Ponikowski, Piotr Spoletini, Ilaria Coats, Andrew J S Piepoli, Massimo F Rosano, Giuseppe M C |
author_sort | Ponikowski, Piotr |
collection | PubMed |
description | It has been long known that incessant tachycardia and severe hypertension can cause heart failure (HF). In recent years, it has also been recognized that more modest elevations in either heart rate (HR) or blood pressure (BP), if sustained, can be a risk factor both for the development of HF and for mortality in patients with established HF. Heart rate and BP are thus both modifiable risk factors in the setting of HF. What is less clear is the question whether routine systematic monitoring of these simple physiological parameters to a target value can offer clinical benefits. Measuring these parameters clinically during patient review is recommended in HF management in most HF guidelines, both in the acute and chronic phases of the disease. More sophisticated systems now allow long-term automatic or remote monitoring of HR and BP and whether this more detailed patient information can improve clinical outcomes will require prospective RCTs to evaluate. In addition, analysis of patterns of both HR and BP variability can give insights into autonomic function, which is also frequently abnormal in HF. This window into autonomic dysfunction in our HF patients can also provide further independent prognostic information and may in itself be target for future interventional therapies. This article, developed during a consensus meeting of the Heart Failure Association of the ESC concerning the role of physiological monitoring in the complex multi-morbid HF patient, highlights the importance of repeated assessment of HR and BP in HF, and reviews gaps in our knowledge and potential future directions. |
format | Online Article Text |
id | pubmed-6937500 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-69375002020-01-06 Heart rate and blood pressure monitoring in heart failure Ponikowski, Piotr Spoletini, Ilaria Coats, Andrew J S Piepoli, Massimo F Rosano, Giuseppe M C Eur Heart J Suppl Articles It has been long known that incessant tachycardia and severe hypertension can cause heart failure (HF). In recent years, it has also been recognized that more modest elevations in either heart rate (HR) or blood pressure (BP), if sustained, can be a risk factor both for the development of HF and for mortality in patients with established HF. Heart rate and BP are thus both modifiable risk factors in the setting of HF. What is less clear is the question whether routine systematic monitoring of these simple physiological parameters to a target value can offer clinical benefits. Measuring these parameters clinically during patient review is recommended in HF management in most HF guidelines, both in the acute and chronic phases of the disease. More sophisticated systems now allow long-term automatic or remote monitoring of HR and BP and whether this more detailed patient information can improve clinical outcomes will require prospective RCTs to evaluate. In addition, analysis of patterns of both HR and BP variability can give insights into autonomic function, which is also frequently abnormal in HF. This window into autonomic dysfunction in our HF patients can also provide further independent prognostic information and may in itself be target for future interventional therapies. This article, developed during a consensus meeting of the Heart Failure Association of the ESC concerning the role of physiological monitoring in the complex multi-morbid HF patient, highlights the importance of repeated assessment of HR and BP in HF, and reviews gaps in our knowledge and potential future directions. Oxford University Press 2019-12 2019-12-31 /pmc/articles/PMC6937500/ /pubmed/31908609 http://dx.doi.org/10.1093/eurheartj/suz217 Text en Published on behalf of the European Society of Cardiology. © The Author(s) 2019. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Articles Ponikowski, Piotr Spoletini, Ilaria Coats, Andrew J S Piepoli, Massimo F Rosano, Giuseppe M C Heart rate and blood pressure monitoring in heart failure |
title | Heart rate and blood pressure monitoring in heart failure |
title_full | Heart rate and blood pressure monitoring in heart failure |
title_fullStr | Heart rate and blood pressure monitoring in heart failure |
title_full_unstemmed | Heart rate and blood pressure monitoring in heart failure |
title_short | Heart rate and blood pressure monitoring in heart failure |
title_sort | heart rate and blood pressure monitoring in heart failure |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937500/ https://www.ncbi.nlm.nih.gov/pubmed/31908609 http://dx.doi.org/10.1093/eurheartj/suz217 |
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