Management of high blood pressure and high heart rate

This paper looked at the management of patients with high blood pressure and elevated heart rate. An elevated heart rate increases the risk of heart disease. 

A meeting by a panel of experts of the European Society of Hypertension examined the issue of elevated heart rate in patients with high blood pressure. Recommendations were made based on the opinions of experts, and previous studies were referenced. 

It is recommended that heart rate is measured in patients with high blood pressure. Before measurement, exercise, smoking, alcohol and coffee consumption should be avoided. The room temperature should be comfortable. The heart rate should be measured by feeling for the pulse over a 30 second period.

Studies show that an elevated heart rate is an important risk factor for cardiovascular disease (disease affecting the heart and blood vessels). Patients with elevated heart rate are more likely to have high blood pressure, high sugar levels, and high levels of fat in the body. 12 studies of patients with high blood pressure showed that a higher heart rate was associated with worse outcomes. In the Glasgow Blood Pressure Clinic Study, patients with high blood pressure and a heart rate that was persistently greater than 80 beats per minute had greater risk of death.  

The management of patients with high blood pressure and heart rate was discussed. The cause of a patient’s elevated heart rate should be identified. Lifestyle changes are recommended. This includes physical activity, stopping smoking, avoiding excessive alcohol and coffee consumption. A change in diet to control weight is also recommended. Results from studies are conflicting as to whether an elevated heart rate in patients with high blood pressure should be treated. However, in patients with symptoms of a high heart rate, a drug that slows the heart such as a beta-1-selective beta-blocker should be considered. 

The authors conclude that an elevated heart rate is a risk factor for heart disease in patients with high blood pressure. Further studies to evaluate the effect of reducing elevated heart rate in patients with high blood is necessary.