Heart rate as a therapeutic target in ischaemic heart disease

A high resting heart rate is associated with an increased risk of ischaemic heart disease (IHD) and sudden death. This relationship is independent of known risk factors such as smoking and dyslipidaemia. It therefore appears sensible to reduce heart rates in IHD patients. Experience in using purl bradycardiac agents is limited. Other drugs which lower heart rate, such as P-blockers have been shown to reduce the risks of sudden death and re-infarction, although their use is restricted because of side effects and contra-indications. Heart rate lowering calcium antagonists are also valuable when used correctly, and not in heart failure. The use of standard and newer heart rate lowering drugs is reviewed.