Journal
CURRENT HYPERTENSION REPORTS
Volume 14, Issue 6, Pages 478-484Publisher
SPRINGER
DOI: 10.1007/s11906-012-0306-3
Keywords
Heart rate; Pulse wave velocities; PWV; Peripheral blood pressure; Central blood pressure; Augmentation index; Hypertension; Cardiovascular disease; Stroke; Chronic kidney disease; CKD; Antihypertensive agents; Beta-blockers
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Funding
- NIDDK NIH HHS [K23 DK087919] Funding Source: Medline
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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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