2018 ESC/ESH Guidelines for the Management of Arterial Hypertension
Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei in Manual of Hypertension of the European Society of Hypertension, 2019
In older people, people with diabetes, or people with other causes of orthostatic hypotension, BP should also be measured 1 and 3 min after standing. Orthostatic hypotension is defined as a reduction in SBP of at least 20 mmHg or in DBP of at least 10 mmHg within 3 min of standing, and is associated with an increased risk of mortality and cardiovascular events [46]. Heart rate should also be recorded at the time of BP measurements because resting heart rate is an independent predictor of cardiovascular morbid or fatal events [47], although heart rate is not included in any cardiovascular risk algorithm. Table 65.8 summarizes the recommended procedure for routine office BP measurement. It is emphasized that office BP is often performed improperly, with inadequate attention to the standardized conditions recommended for a valid measurement of office BP. Improper measurement of office BP can lead to inaccurate classification, overestimation of a patient’s true BP, and unnecessary treatment.
Assessment for Rehabilitation of COVID-19
Wenguang Xia, Xiaolin Huang in Rehabilitation from COVID-19, 2021
Respiratory gas analysis is a noninvasive method for measuring gas metabolism. When patients develop heart or lung disease, oxygen intake volume and related indexes will change significantly. The measurement can be carried out by a specific pulmonary function instrument to measure the oxygen consumption in the resting state, after quantitative activities and in the convalescent period, respectively, or to measure the maximum oxygen consumption with maximal exercise capacity or the oxygen consumption per minute during one specific activity. Heart rate should be recorded at the same time during the measurement. Pulmonary ventilation per minute should be recorded. Then, oxygen uptake, oxygen equivalence, carbon dioxide equivalence, oxygen pulse, and respiratory quotient, etc., can be calculated according to the measured indexes, the oxygen difference between exhaled air and atmosphere, and carbon dioxide difference.
The patient with acute cardiovascular problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
Sinus tachycardia is a regular heart beat that originates from the sinoatrial node, but at a rate faster than 100 beats per minute (please see Figure 6.27). The resting heart rate will not normally be above 100 beats per minute, so the patient should be carefully assessed to determine the cause of the tachycardia. Sinus tachycardia is non-paroxysmal, that is, it doesn’t start or end abruptly, which is a feature of other tachy-arrhythmias. It would seem logical that an increased heart rate would always improve cardiac output and tissue perfusion, but this is not always the case. You may remember that the heart spends a larger proportion of the cardiac cycle in diastole, the filling phase. As the heart rate increases, it is the diastolic phase which shortens, and as the rate moves towards 140, the time for ventricular filling significantly reduces, so cardiac output may fall. Shortened diastole can also lead to a reduction in coronary artery blood flow, resulting in angina, increasing areas of myocardial ischaemia and infarction as the oxygen supply cannot meet the demand of the rapidly contracting myocardium. Ensuring that the patient is not hypoxaemic and is adequately filled, or not dehydrated, is a good starting point.
Preconceptual leptin levels in gestational diabetes and hypertensive pregnancy
Published in Hypertension in Pregnancy, 2022
Antti Peltokorpi, Lisinen Irina, Viikari Liisa, Kaaja Risto
Mendoza et al. (26) reported higher RHR in pregnant women at <28 gestational weeks as a risk factor for GDM. Our study didn’t find association between pre-pregnancy measured RHR and GDM. Resting heart rate could indicate, although not as a perfect indicator, sympathetic activity especially at heart level. Increased central sympathetic activity as an inducer of increased insulin resistance, seems to prevail after pre-eclamptic pregnancy (27). Positive correlation between resting heart rate and circulating leptin, independent of BMI, have been demonstrated in a study consisting of 2264 males and 2545 females (28). Our results were similar as we found an interesting, yet mild correlation between leptin and RHR in our healthy subjects (Spearman correlation = 0.20; p = 0.015) To be noted, correlation wasn’t significant in GDM group (Spearman correlation = 0.049; p = 0.69), due to which leptin’s inducing effect on RHR and sympathetic activity in association with subsequent GDM cannot be claimed by our results. This raises the question whether individuals with subsequent GDM, had suppressed leptin’s impact on RHR.
Role of ivabradine and heart rate lowering in chronic heart failure: guideline update
Published in Expert Review of Cardiovascular Therapy, 2018
Sheryl L Chow, Robert L. Page, Christophe Depre
Among healthy adults, an increasing resting heart rate is independently and directly associated with risk for HF, cardiovascular mortality, and overall mortality [18–22]. A meta-analysis of 7073 patients from 3 prospective cohorts and an analysis of 4768 patients from the Rotterdam Study demonstrated a 13–16% increased risk of developing HF associated with each 10 bpm increase in resting heart rate [20,21]. The prospective National FINRISK Study involving 21,853 patients found a 24–32% increased risk of cardiovascular mortality and a 19–21% increase in overall mortality associated with each 15 bpm increase in resting heart rate [18]. Among adults with preexisting coronary artery disease, increasing heart rate potentiates risk for cardiovascular mortality and rehospitalization due to multiple cardiovascular causes, including HF [23]. In a retrospective analysis of 24,912 patients from the Coronary Artery Surgery Study, a heart rate of ≥77 bpm was statistically significantly associated with a higher risk for rehospitalization due to HF compared to heart rates in the lowest quintile, defined as ≤62 bpm (P<0.01; hazard ratios [HR]=1.22 [heart rates of 77–82 bpm]; 1.32 [heart rates of ≥83 bpm]). In patients with preexisting HF, resting heart rate is a strong predictor for adverse outcomes and is directly associated with increased overall mortality, cardiovascular mortality, and HF hospitalization [10–13]. Ford et al. demonstrated an increased relative risk of 25–32% in these end points associated with every 10-bpm increase in heart rate [12].
A nonlinear association between resting heart rate and ischemic stroke among community elderly hypertensive patients
Published in Postgraduate Medicine, 2020
Yu-Qing Huang, Geng Shen, Jia-Yi Huang, Bin Zhang, Ying-Qing Feng
Resting heart rate is a simple but effective indicator of the autonomic nervous system tone, reflecting autonomic balance and metabolic rate [1]. Therefore, resting heart rate is useful for cardiovascular risk stratification [2,3]. Previous studies demonstrated that resting heart rate significantly associated with cardiovascular death and the risk of all-cause mortality in different populations [2,4–7]. Besides, a higher resting heart rate was an independent risk factor for ischemic stroke [8–11], but the relationship was not entirely consistent. Studies from China [12] and Sweden [13] did not find a significant relationship between resting heart rate and ischemic stroke. In addition, how resting heart rate relate to ischemic stroke in different subpopulations is also unknown, especially in elderly hypertension patients. Therefore, in the present study, we aimed to investigate the potential association between resting heart rate and ischemic stroke in Chinese community elderly hypertensive patients.
Related Knowledge Centers
- Bradycardia
- Carbon Dioxide
- Cardiac Cycle
- Oxygen
- Psychological Stress
- Tachycardia
- Heart
- Body
- Physical Fitness
- Pulse