What should hypertensive patients do if their heart rate is found to be too fast during physical examination?

Patients with hypertension who are found to have a high heart rate during physical examination can intervene by adjusting their lifestyle, monitoring blood pressure and heart rate, following medical advice to adjust antihypertensive drugs, screening for secondary diseases, and using heart rate control drugs if necessary. A faster heart rate may be related to factors such as sympathetic nervous system excitation, drug side effects, combined hyperthyroidism or arrhythmia.

1. Adjust lifestyle

Reduce caffeine and alcohol intake, and keep daily sodium intake below 5 grams. Maintain a regular daily routine, avoid staying up late and excessive fatigue, and it is recommended to engage in 150 minutes of moderate intensity aerobic exercise such as brisk walking or swimming every week. Relieving mental stress through deep breathing training, meditation, and other methods can help reduce sympathetic nervous system excitability.

2. Monitor blood pressure and heart rate

Measure blood pressure and pulse at rest in the morning and evening, and record fluctuations. Be alert when the resting heart rate continues to exceed 80 beats per minute or is accompanied by palpitations or chest tightness. It is recommended to use a certified upper arm electronic blood pressure monitor, sit quietly for 5 minutes before measurement, and avoid smoking, drinking tea, or exercising within 30 minutes before measurement.

3. Adjusting the antihypertensive regimen

Some antihypertensive drugs such as nifedipine controlled-release tablets and diltiazem hydrochloride sustained-release capsules may cause reflexive heart rate increase. Doctors may switch to beta blockers such as metoprolol extended release tablets and bisoprolol fumarate tablets, which have both antihypertensive and heart rate control effects, depending on the situation. Do not adjust the type or dosage of medication on your own.

4. Screening for secondary diseases

requires comprehensive examinations such as thyroid function, blood routine, and dynamic electrocardiogram. Hyperthyroidism can cause sinus tachycardia, characterized by excessive sweating, weight loss, and increased heart rate. Paroxysmal supraventricular tachycardia and other arrhythmias should be diagnosed through electrocardiogram, and if necessary, structural lesions should be evaluated by echocardiography.

5. Heart rate control drugs

For patients with persistent tachycardia, doctors may prescribe metoprolol tartrate tablets to reduce myocardial oxygen consumption, or sustained-release verapamil hydrochloride tablets to inhibit sinoatrial node excitability. Severe cases require consideration of radiofrequency ablation treatment, and drug selection should balance the dual goals of blood pressure control and heart rate management. Patients with hypertension and increased heart rate should maintain a low-fat and low salt diet, and increase their intake of potassium and magnesium rich foods such as celery and bananas. Avoid sudden intense exercise, and the heart rate during exercise should not exceed 170 minus the age limit. Recheck blood pressure and heart rate every month. If there is persistent chest pain, fainting, or a heart rate exceeding 120 beats per minute, seek medical attention immediately. Long term uncontrolled increase in heart rate may exacerbate cardiac burden, increase the risk of heart failure and arrhythmia.