On the eve of World Hypertension Day, the heart rate map of Chinese hypertensive patients was first released. The project screened >1,818,627 hypertensive patients. The data (Figure) suggest that heart rate control in Chinese hypertensive patients is not optimistic: large In some provinces and cities, the heart rate of patients over 30% exceeds 80 beats/min, and the treatment status needs to be improved. This article will analyze the importance of heart rate management in hypertension patients and related data, in order to inspire the reader's clinical practice.
Heart rate management in patients with hypertension is imperative
Cardiovascular disease is a major threat to the health of our people. The "China Cardiovascular Disease Report 2015" shows that cardiovascular deaths account for the first cause of total deaths in urban and rural residents, higher than cancer and other diseases.
There are 270 million patients with hypertension in China. In 2010, there were 2.03 million deaths due to hypertension in China, accounting for 24.60% of all deaths. In 2013, the direct economic burden of hypertension accounted for 6.61% of China's total health expenditure. Controlling cardiovascular risk factors and strengthening the screening and management of diseases such as hypertension can help reduce the risk of patient endpoints and reduce the health and financial burden of patients.
Sympathetic activation is one of the important mechanisms of hypertension. Heart rate is a reliable indicator of sympathetic activation. Prevention and control of hypertension should focus on heart rate management. Increased heart rate can lead to a significant increase in systolic and diastolic blood pressure, increasing the risk of cardiovascular adverse events in patients with hypertension.
As in the Framingham study, the risk of cardiovascular death in patients with hypertension increases with increasing heart rate, suggesting that heart rate may be an independent risk factor for cardiovascular death in hypertensive patients. The VALUE study suggests that even if blood pressure is well controlled, heart rate increases the risk of cardiovascular events in hypertensive patients.
The guidelines also confirm the importance of heart rate management in patients with hypertension. For example, the European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines for hypertension management recommended in 2013, all patients with hypertension should pay attention to monitoring heart rate. In 2016, ESH hypertension patients with increased heart rate management consensus pointed out that heart rate should be an important indicator for comprehensive assessment of hypertension patients, and called for inclusion in cardiovascular risk stratification indicators. In 2016, the consensus of heart rate management experts in hypertension patients in Europe pointed out that elevated heart rate is an important risk factor for cardiovascular disease, and heart rate testing should be included in the comprehensive assessment of hypertension. The heart rate threshold for interventions, although difficult to define clearly, should be given clinical attention when the resting heart rate is >80-85 beats/min.
It can be seen that heart rate should be a new target for hypertension management, and the heart rate management pioneer action came into being. Focusing on heart rate management and control in patients with hypertension can help improve blood pressure control rate and reduce the risk of cardiovascular events in patients, which is very important for the prevention and treatment of cardiovascular diseases in China.
Heart rate map suggests that the current situation of heart rate control in Chinese patients with hypertension needs to be improved
The current situation of heart rate control in Chinese patients with hypertension is not optimistic. The heart rate map of Chinese hypertensive patients released this time shows that except for the areas where there is currently no data and Inner Mongolia, Sichuan, and Anhui, the proportion of hypertensive patients with heart rate of more than 80 beats/min in most provinces and cities in China is higher than 30%. The proportion of hypertensive patients with heart rate over 80 beats/min in Hebei, Liaoning, Hunan, Guizhou, Guangxi and other provinces is higher than 40%, and the proportion of hypertension patients with heart rate over 80 beats/min in Shanghai, Tianjin, Chongqing, Zhejiang, Guangdong and other provinces is high. At 33%.
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