Heart rate and blood pressure: any possible implications for management of hypertension?

Heart rate and blood pressure: any possible implications for management of hypertension?
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DOI:
10.1007/s11906-012-0306-3
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发表时间:
2012-12
影响因子:
5.6
通讯作者:
Drawz, Paul E.
Drawz, Paul E.
中科院分区:
医学2区
文献类型:
--
作者:
Reule, Scott;Drawz, Paul E.

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高血压是常见的临床问题,也是心血管疾病和中风的主要危险因素。心率升高与血压升高、高血压风险增加有关,在高血压患者中,还会增加心血管疾病的风险。尽管有这些重要的关系,心率通常不是选择降压药的主要考虑因素。在一定程度上,这是因为缺乏证据支持将降低心率作为高血压的治疗策略。此外,虽然心率与外周血压呈正相关,但心率与中心血压呈负相关。使用抗高血压药物,特别是影响心率的药物,可能不会可靠地降低中心血压,达到与外周观察到的类似程度。我们回顾了心率与外周和中心血压的关系,重点讨论了高血压变时性治疗的意义。
Hypertension is a common clinical problem and a major risk factor for cardiovascular disease and stroke. Elevated heart rate is associated with elevated blood pressure, increased risk for hypertension, and, among hypertensives, increased risk for cardiovascular disease. Despite these important relationships, heart rate is generally not a major consideration in choosing antihypertensive medications. In part, this is due to a lack of evidence supporting heart rate lowering as a therapeutic strategy in hypertension. Additionally, while there is a positive correlation between heart rate and peripheral blood pressure, there is an inverse relationship between heart rate and central blood pressure. The use of antihypertensive medications, specifically medications that affect heart rate, may not reliably reduce central blood pressure to a similar extent as observed peripherally. We review the relationship between heart rate and peripheral and central blood pressure, with a focus on the implications for chronotropic therapy in hypertension.
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