Med. praxi. 2025;22(4):236-241 | DOI: 10.36290/med.2025.053

The effect of noctural heart rate on mortality in patients with arterial hypertension

prof. MUDr. Tomáš Kovárník, Ph.D.
II. interní klinika VFN a 1. LF UK v Praze

Elevated resting heart rate, particularly during nighttime, is a significant yet often overlooked predictor of all-cause and cardiovascular mortality in patients with arterial hypertension. It reflects the state of autonomic regulation and the balance between sympathetic and parasympathetic activity. Nighttime heart rate has greater prognostic value than daytime rate, and an insufficient nocturnal decline is associated with increased cardiovascular risk, psychological comorbidities, and reduced life expectancy. This review summarizes current evidence on the pathophysiology, diagnosis, and therapeutic strategies for elevated heart rate, including both pharmacological and non-pharmacological approaches. Special attention is given to the synergistic effects of beta-blockers with ACE inhibitors and the role of psychotherapeutic interventions such as ketamine-assisted therapy.

Keywords: nighttime heart rate, arterial hypertension, autonomic dysregulation, cardiovascular mortality.

Received: June 23, 2025; Accepted: June 23, 2025; Published: September 29, 2025  Show citation

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Kovárník T. The effect of noctural heart rate on mortality in patients with arterial hypertension. Med. praxi. 2025;22(4):236-241. doi: 10.36290/med.2025.053.
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