BLOOD PRESSURE CONTROL OF HYPERTENSIVE PATIENTS WITH HIGH HEART RATE (RESULTS FROM NATURE HTN). (April 2021)

• Record Type: Journal Article
• Authors: Hammami, Rania; Bahloul, Amine; Charfeddine, Salma; Triki, Faten; Ellouze, Tarek; Abdessalem, Salem Ben; Zakhama, Lilia; Added, Faouzi; Abid, Leila
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000747688.99989.03
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: High heart rate (HHR) is related to sympathic hyperactivity and. Betablockers are downgraded in the management of hypertension, however many studies showed that HHR is associated with elevated blood pressure and increased risk for cardiovascular disease. We aimed in this work to analyze the clinical profile of patients with HHR and to assess the implication of this finding on blood pressure control, based on data from the largest Tunisian national registry Nature HTN Design and method: Nature HTN is a national multicentric study conducted by the Tunisian society of cardiology and including hypertensive patients who consulted their doctors during one month in 2019. We defined HHR by a HR higher or equal to 80bpm. We compared two groups, group1 = HR lower than 80 bpm and group 2: HR higher than 80 bpm. Results: We enrolled 25890 hypertensive patients, with female predominance (SR = 1.2) and mean age 64.4 ± 12.2 yo. The hypertension was newly diagnosed in 2286 patients (8.8%) and known more than six months in 23601 persons. The mean HR was 73.8 ± 11 (extremes: 40–150). HHR was found in 4878 patients (19.2%). Patients of group 2 were more frequently female (56.5% versus 43.5%, p = 0.009). The prevalence of HHR were higher in diabetic (21 versus 18%, p < 0.001), smokers (21.4% versus 18.8%, p < 0.001) and obese (21.3% versus 18.2%, p < 0.001), patients with apnea syndrome (26.5% versus 19%, p < 0.001), patients with atrial fibrillation (29.9% versus 18.3%, p < 0.001). Patients of group 1 practiced physical activity more frequently than group 2 (15.8% versus 11.6%, p < 0.001), and are more compliant to drug and salt intake. BP control was lower in patients with HHR (40.5% versus 52.4%, p < 0.001). HHR was found as a predictor of uncontrolled BP on multivariate analysis (OR = 1.59, 95% CI (1.48–1.71), p < 0.001). Conclusions: Our study showed that HR is an integral part of the assessment of the hypertensive patient. Older beta-blockers do not low the central pressure and that s why no effective on cardiovascular events. Newer beta blockers are efficient on central blood pressure and could be largely used in the management of Hypertension.