Tag Archives: heart rate

Introduction Beta-adrenoceptor blocking drugs (beta blockers) are an established prognostic therapy for chronic heart failure (HF).1-4 Of the many proposed mechanisms mediating these favourable effects, that of heart rate (HR) control is gaining interest. The Systolic Heart Failure Treatment with Iƒ Inhibitor Ivabradine Trial (SHIFT) reported that ivabradine significantly reduced a combined end point of cardiovascular death or HF hospitalisations in a relatively high-risk HF population with an elevated resting HR.5 HR control, therefore, appears to be both a modifiable risk factor and a disease modifying variable in patients with impaired l

Navigating the changing landscape of cardiovascular commissioning A clear majority (58%) of GPs with a special interest in cardiology (GPSIs) feel unprepared to fulfill a commissioning role in the new NHS landscape, despite almost half of GPs being currently involved in commissioning, according to results from the REACCT (REAssessing Cardiology Commissioning and Treatment) report announced at the meeting. The report also reveals that a majority of cardiologists (57%) feel unprepared to take on new commissioning roles around the management of cardiovascular disease (CVD). The report (available from: www.pccs.org.uk/report) was written by the P

The new guideline from the National Institute for Health and Clinical Excellence (NICE)1 covers adults who have been diagnosed with stable angina due to atherosclerotic disease, following on from clinical guideline 95,2 which advises on diagnosis of chest pain of recent onset. A key priority for implementation in the latest guidance is to ensure that people with stable angina receive balanced information and have the opportunity to discuss the benefits, limitations and risks of their treatment. Initial management of stable angina should be to offer optimal drug treatment, addressing both the angina itself and secondary prevention of cardiovas

Neurohormonal blockade A cardiac resynchronisation therapy pacemaker (CRT-P), provides cardiac resynchronisation therapy and diagnostics to assist in patient management The meeting set off to a stimulating start with Professor Theresa McDonagh (Kings College Hospital, Chair of the British Society of Heart Failure) reviewing primarily the growing evidence for aldosterone antagonists in the management of systolic heart failure (HF). Large clinical trials have established the role of aldosterone antagonists, such as spironolactone, in severe systolic HF (Randomised Aldactone Evaluation Study – RALES) and eplerenone in acute myocardial infarcti

Introduction It has been estimated that about two million people in the UK experience the painful and debilitating symptoms of angina – one million men and more than 920,000 women.1 About 17% of men and 8% of women aged 65–74 have been diagnosed with angina at some point in their lives2 and there are about 338,000 new cases of angina each year.1 Not only does angina pose a considerable burden on patients and their carers, it also represents a significant financial burden, costing the National Health Service (NHS) about £700 million each year.3 Alongside the physical trauma of symptoms experienced by patients, angina also detrimentally af

Introduction An elevated heart rate may be a primary determinant of myocardial ischaemia by altering the balance of oxygen demand and coronary perfusion. Given that there is considerable evidence showing survival is inversely related to heart rate, lowering heart rate would be expected to be an important tool in the management of angina.1-3 Theoretically it may also be beneficial in the prevention of myocardial infarction as the haemodynamic stresses placed upon the myocardium by a high heart rate are associated with coronary plaque rupture.4 Approaches to lowering heart rate include the use of beta blockers and certain calcium channel blocke

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