In the morning clinic, there is a patient with high blood pressure, and it is worth sharing with you today.
The patient male, 49 years old, hypertension for 3 years, blood pressure up to 180/110mmHg, and later took 2 antihypertensive drugs, twice a day, blood pressure control at about 140/90mmHg.
For a 49-year-old, the ideal blood pressure is close to 120/80mmHg, and this patient's blood pressure has not been up to standard. He had already taken two pills, and twice, so he was reluctant to add any more.
3 months ago, looking for my first consultation, the blood pressure situation is still above, but I found that his heart rate is 90 beats / min, at first I thought he was more nervous, let him rest for a minute to measure again, or 90 beats / min.
I told him that people with high blood pressure, the heart rate can not be too fast, otherwise the blood pressure is not easy to control, the most critical, the risk of long-term cardiovascular and cerebrovascular diseases will increase.
In general, we recommend that when people with high blood pressure, the resting heart rate, that is, the heart rate during quiet rest, if it exceeds 80 beats per minute, it should be treated with a lowering heart rate. The patient said: I am not uncomfortable, I do not feel fast, maybe I have adapted to this heart rate.
I said: Adapting to this kind of fast, this statement may be correct. But we can't say that there is no discomfort, so we don't care. Because your current blood pressure is not up to standard, and the long-term heart rate is too fast, it will also increase the risk of coronary heart disease, atrial fibrillation, heart failure and other diseases, so it is still recommended to match a little heart rate drug to reduce the heart rate to about 70 times / minute.
Today, the patient is three months after the drug adjustment, the patient's heart rate is 72 times / min, blood pressure is 124/82mmHg, the heart rate has come down, and the blood pressure is close to the ideal level.
So the heart rate of high blood pressure is fast, should be lowered heart rate, in the end is there any evidence?
Peking University's latest research:
The research group of Peking University People's Hospital divided hypertension volunteers from 110 hypertension centers in 21 cities in China into 5 groups according to their resting heart rate, namely:
Heart rate ≥ 80 beats/min, heart rate 75-79 beats/min, heart rate 70-74 beats/min, heart rate 65-69 beats/min, heart rate < 65 beats/min.
A total of two years of follow-up observation ruled out factors such as age, sex, alcohol consumption, smoking, blood lipids, blood sugar, and coronary cardiovascular and cerebrovascular diseases. The main observations were: myocardial infarction, cardiac stents, cardiac bypass, atrial fibrillation, heart failure, cerebral infarction, cerebral hemorrhage, death and other cardiovascular disease events.
Compared with hypertensive patients with a heart rate of about 70-74 beats per minute, the incidence of cardiovascular disease events increased by 45% compared with hypertensive patients with a heart< rate of about 70-74 beats per minute;
Compared with hypertensive patients with a heart≥ rate of about 70-74 beats per minute, the incidence of cardiovascular disease events increased by 39% compared with hypertensive patients with a heart rate of about 70-74 beats per minute, and the incidence of cardiovascular disease was increased by 39%;
Conclusion: For people with high blood pressure, if the heart rate ≥ 80 beats per minute or the heart rate < 65 beats per minute will increase the risk of cardiovascular and cerebrovascular diseases. This condition is more pronounced in men with hypertension, as well as in patients with hypertension in advanced age.
In people with high blood pressure, controlling the heart rate at 65 to 79 beats per minute can reduce the risk of cardiovascular disease events in patients with hypertension.
Therefore, for friends with high blood pressure, in addition to monitoring their blood pressure, they should also monitor their heart rate, if the heart rate is fast, especially the resting heart rate is more than 80 times / min, or less than 65 times / min, then you need to find a doctor to further adjust the program.
Hypertension with heart disease
Of course, this is talking about patients with simple hypertension, but for patients with hypertension complicated with heart disease such as angina, myocardial infarction, and heart failure, the ideal heart rate is not 65-79 beats / min.
When we diagnose and treat patients with angina, heart failure, and myocardial infarction, we generally require that the patient's heart rate be reduced to about 60 times / min, so when a person has high blood pressure, and there are coronary heart disease, angina, myocardial infarction, heart failure and other diseases, the heart rate should drop to about 60 beats / minute.
In short, friends with high blood pressure, in the future, to have one more heart eye, in addition to monitoring blood pressure, but also to monitor the heart rate!
Heart rate should not be too fast should not be too slow, it is best to control at 65-79 times / min!