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#1
Old 09-19-2003, 05:16 PM
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Relationship between Heart Rate and Blood Pressure

What is the relationship between heart rate and blood pressure? For example, if I lowered my blood pressure through taking medication, would my heart rate tend to rise less during exercise? When my heart rate is higher, is my blood pressure also higher? Are these different measures of the same thing, or measures of different things, related or unrelated?
#2
Old 09-19-2003, 06:34 PM
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It is a multi-factorial thing. Having said that, for the average individual, if heart rate goes up with exercise, blood pressure does too. I've personally verified this phenomenon by having done over 1000 cardiac stress tests over 10 years. When the exercise is over and the heart rate goes down, the pressure goes down too.

However, much depends on the situation. If blood pressure is lowered by means of a medication called a beta-blocker (propranolo. metoprolol, atenolol), the heart rate won't rise as much with exercise, as the medication reduces the ability of the heart to beat faster. Other blood pressure lowering meds don't have this effect.

Sometimes one's heart rate is up because one's blood pressure is down. This occurs often when there's not enough blood volume to maintain normal pressure and perfusion of tissues, so the heart reflexively beats faster to try to maintain pressure and perfusion.

Sometimes one's pressure is up because one's heart rate is down. If the heart slows too much, the body constricts the arteries to try to maintain pressure, and manages to elevate the pressure.

Sometimes one's pressure is down because one's heart rate is down. The heart may be beating too slow, and the body can no longer manage to constrict the vessels enough to raise the pressure to compensate, so pressure drops.

There are many other scenarios. It is complicated. It mostly depends on the reason for the heart rate to be up, or down.

To summarize, in an otherwise healthy, medication-free exercising individual, pressure rises with heart rate. But it would be wrong to say that there's a one to one correlation between cause and effect vis a vis heart rate and blood pressure!

Confused enough yet?

QtM, MD
#3
Old 09-19-2003, 10:10 PM
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What Q the M said. Plus, understand that standard measures and counts are all guidelines, not hard rules.

The general health and overall condition of the individual, including age, family history and other factors must be reviewed.

I personally have seen a number of people placed on meds for hypertension after one high BP reading...including myself, which I declined.

Maybe Q the M can add to this concern I have, but basing the decision to prescribe meds almost exclusively on one BP test (not all the info that's been mentioned) is a bit alarming.
#4
Old 09-19-2003, 10:25 PM
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One should not prescribe a blood pressure medication for a single isolated blood pressure elevation (unless it it acutely dangerously high, say 230/140 or so. Then bring it down with drugs, and figure why it was so high).

A diagnosis of hypertension depends on 3 separate elevated blood pressure readings, taken with the patient either sitting with feet on the floor, or lying one ones back, quietly for 5 minutes. Once 3 measurements are taken on different days or weeks (and other factors like kidney, thyroid disease, use of stimulants like caffiene, sudafed, cocaine, etc. are ruled out) then it would be wise to begin treating for elevated BP.

Quote:
What is elevated BP?
Blood pressure stages
Prehypertension: (120 to 139/80 to 89 mm Hg). Treat with lifestyle modification, Drug therapy in patients with diabetes mellitus or chronic kidney disease
Stage 1: (140 to 159/90 to 99 mm Hg) Consider coexisting conditions, Treat with lifestyle modifications, thiazide-type diuretics for most patients
Stage 2: (>=160/>=100 mm Hg) Consider coexisting conditions, treat with lifestyle modifications, two-drug combination for most patients
from: http://aafp.org/afp/20030901/853.html
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