高血压患者的心率控制在多少比较合适呢?
一、高血压需要控制心率吗?
高血压(hypertension)是指以体循环动脉血压(收缩压和/或舒张压)增高为主要特征(收缩压≥140毫米汞柱,舒张压≥90毫米汞柱),可伴有心、脑、肾等器官的功能或器质性损害的临床综合征。高血压是最常见的慢性病,也是心脑血管病最主要的危险因素。高血压当然要控制心率,而且高血压患者控制心率是明确的写在指南中的,高血压控制心率,不仅仅可以减少心室率,减少心肌耗氧,还可以降低交感神经张力,从而更好降低血压,而且可以减少高血压相关并发症!所以,许多的研究资料显示,高血压控制心率的获益还是相当有用,获益很多!
二、高血压心率开始干预的标准是多少?
心率是指正常人安静状态下每分钟心跳的次数,也叫安静心率,一般为60~100次/分,可因年龄、性别或其他生理因素产生个体差异。心率越快,往往反应交感神经张力越高,而且提示预后!在2017年的《高血压患者心率管理中国专家共识》中明确规定了我国心率干预切点的指标为:静息心率>80bpm;24小时动态心率>75bpm。也就是说,当静息状态时心率>80次/分,或者动态心电图提示24小时平均心率>75次/分,往往提示我们需要加以干预!
三、高血压心率控制的目标是多少?
高血压控制到多少合适?这个也需要不同情况不同区别,针对不同患者人群的心率目标其标准是不一样的,比如,1、高血压合并心房颤动患者建议心室率<110次/分; 2、高血压合并冠心病患者建议静息心率控制在50-60次/分; 3、高血压伴主动脉夹层患者建议心率控制在50-60次/分。当然,如果没有合并其他疾病,那么单纯的高血压,我们也建议心率控制在70-75次/分以内!
高血压不仅仅要血压达标,心率也要达标,才能获得最大获益!
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