heart rate as a main risk factor for cardiovascular disease. However, translating research into

clinical practice has been a challenge throughout medical history. From the present

symposium, it appears clear that this is particularly the case for heart rate. The complex

nature of atherogenesis makes it difficult to establish the role of a putative risk factor because

of the correlations and complex interactions among factors. The pathogenetic mechanisms for

the connection of resting heart rate with atherosclerosis and cardiovascular morbidity have

been elaborated extensively in the chapter papers of this symposium, suggesting that there is

a causal relationship between heart rate and cardiovascular mortality. The benefit of heart rate

reduction has been proved in patients with coronary artery disease or congestive heart failure.

Until now it has been difficult to determine whether modulation of heart rate is beneficial also

in patients free of cardiac diseases. This concern, however, does not in any fashion suggest

that health care professionals should pay less attention to this clinical variable. The

impressive amount of available epidemiologic data show support for the continued effort to

raise awareness of the clinical importance of resting heart rate among health care

professionals. (Prog Cardiovasc Dis 2009;52:1-5)