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High heart rate may raise health risks.

INDIVIDUALS HEAR CONSTANT REMINDers to know their blood pressure and cholesterol levels and to seek treatment when the numbers suggest increased risk for cardiovascular problems. Some experts say that both patients and their physicians should pay the same attention to heart rate. A rapid resting heart rate, but one considered to be within the normal range (generally 60-100 beats/min), is frequently dismissed during a routine annual checkup, with the high beat count attributed to white-coat syndrome. Also, a high but normal heart rate may not garner much concern from an examining physician if it is associated with confounding factors such as being overweight or being unfit, as getting a patient to lose weight or exercise will reduce cardiovascular disease risk and lower the heart rate as a bonus. But some researchers argue that heart rate deserves greater attention: that the normal range is a misnomer and individuals with resting heart rates above 80/min are at increased risk from cardiovascular complications. And new research suggests high heart rates are also associated with poor renal outcomes. An article by researchers at Johns Hopkins University in Baltimore and the University of North Carolina in Chapel Hill suggests that a high resting heart rate and low heart rate variability may be risk factors for endstage renal disease and hospitalizations related to chronic kidney disease (Brotman DJ et al. J Am Soc Nephrol. doi:10 .1681/ASN.2009111112 [published online July 8, 2010]). Daniel J. Brotman, MD, lead author and director of the hospitalist program at Johns Hopkins Hospital, said he believes that physicians do not consider resting heart rate as seriously as they should. “People are not convinced that abnormal autonomic tone can cause kidney disease,” said Brotman.