Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, 55414, USA.
Curr Hypertens Rep. 2012 Dec;14(6):478-84. doi: 10.1007/s11906-012-0306-3.
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.
高血压是一种常见的临床问题，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、高血压风险增加以及高血压患者心血管疾病风险增加有关。尽管存在这些重要的关系，但心率通常不是选择抗高血压药物的主要考虑因素。部分原因是缺乏支持降低心率作为高血压治疗策略的证据。此外，虽然心率与外周血压之间存在正相关关系，但心率与中心血压之间存在负相关关系。抗高血压药物的使用，特别是影响心率的药物，可能无法可靠地降低中心血压，其降低程度与外周观察到的程度相似。我们回顾了心率与外周和中心血压之间的关系，并重点探讨了高血压患者变时治疗的意义。
