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A substantial volume of data indicates that an elevated HR is independently associated with increased cardiovascular morbidity and mortality in the general population, in subjects with cardiovascular diseases, and those with diabetes [13, 14, 38, 39]

References Bala S, Allan KC, Decker NL, et al

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Consider: Baseline blood pressure and heart rate measurement before starting combination therapy Regular monitoring during dose titration of either medication Prompt evaluation of palpitations, chest pain, or shortness of breath Caution in patients with pre-existing cardiovascular disease , including coronary artery disease, arrhythmias, or uncontrolled hypertension ECG evaluation if indicated by clinical history or symptoms Nutritional adequacy must be maintained