OBJECTIVES Estimate the economic value of heart rate (HR) control in stable angina (SA) patients in the perspective of the Brazilian Public Health System (Sistema Único de Saúde - SUS). METHODS A Markov chain Monte Carlo stochastic simulation model was used to estimate the influence of HR in cardiovascular (CV) morbidity and mortality and its economic consequences to SUS. Resting HR distribution was modelled as a gamma function. Overall survival and time to hospitalization were modelled with weibull survival functions. Only CV events (acute myocardial infarction, stroke, heart failure and death) and revascularization procedures (coronary artery bypass graft and percutaneous coronary interventions) costs were considered. Brazil's health context was taken into account, including baseline characteristics of SA patients, resource utilization and direct costs (no indirect costs were included), reflecting SUS perspective. Annual discount rate was 5% and time horizon 20 years. RESULTS Reduction in SUS direct costs, per patient, would range from R$147 (95%CI=[R$136;R$159]) to R$354 (95%CI=[R$321;R$388]) for each 5 bpm decrease in HR up to 20 bpm, 70% of these costs reductions resulting from avoidable revascularization procedures. In patients with HR>70 bpm (average HR: 87 bpm), a 10 or 20 bpm HR reduction would decrease SUS per patient average direct cost by R$404 (95%CI=[R$393;R$415]) or by R$611 (95%CI=[R$598;R$625]), respectively. Only 33% of the 2.5 million Brazilian SA patients take beta-blockers and might potentially have the recommended resting HR (50-60 bpm). Thus, a 10 bpm reduction from the average HR for the overall SA population (74 bpm) could reduce SUS direct cost by over R$450 million. CONCLUSIONS These results show that effective lowering heart rate strategies may contribute to substantial savings of public funds in Brazil. Therefore, heart rate must be regarded as an important CV risk factor from an economic point of view.