Heart rate is a technical term used to describe the cardiac cycle, which refers to the number of heartbeats per minute, based on the first sound. Currently, some hypertensive patients have an “excessive” heart rate. If the heart rate is too fast, the risk of coronary heart disease and death will increase, so when hypertensive patients control their blood pressure, they also need to get their heart rate up to standard. In general, the pulse and heart rate are the same, while the heart rate is accelerated, it may be due to sympathetic excitement. Sympathetic excitation and hypertension are causally related – a high heart rate increases the probability of hypertension, while high blood pressure also causes damage to heart function, resulting in a faster heart rate. For patients with hypertension, both heart rate management and blood pressure management are important. When the heart rate exceeds 80 beats per minute, it should be alerted and managed. However, in life, patients with hypertension often neglect to monitor their heart rate, and many are not even aware of the dangers of a rapid heart rate. In fact, the faster a hypertensive patient’s heart rate is, the higher the risk of coronary heart disease and death, which is why blood pressure monitors display the value of heart rate in addition to the blood pressure value. Which patients need extra attention? Currently, more than 30% of our hypertensive patients have a heart rate of more than 80 beats per minute, and these patients are commonly young and middle-aged. In other words, young and middle-aged people with increased blood pressure often have sympathetic hyperactivation, mainly in the form of increased heart rate, and these patients are characterized by increased heart rate in situations of anxiety and stress. In addition, people with obesity and poor lifestyles also have faster heart rates than others. It is important to emphasize that heart rate compliance in hypertensive patients can greatly reduce the occurrence of malignant events such as sudden death, myocardial infarction and stroke, as well as effectively improve the quality of life of patients. Therefore, young and middle-aged hypertensive patients and patients with hypertension combined with coronary artery disease or heart failure should pay special attention to their heart rate changes and monitor them regularly. For the management of heart rate in hypertensive patients, both lifestyle and pharmacological interventions can be carried out. In terms of lifestyle, firstly, patients need to have a reasonable diet, insist on limiting salt, limiting alcohol, and eating less fast food, etc. Secondly, patients need to engage in regular physical activities, either by doing housework or various exercises. Finally, whether facing life or work, one should maintain a calm state of mind and reduce emotional stimulation. In the premise that lifestyle adjustment is fruitless, patients can use drugs that inhibit sympathetic nerves and lower heart rate at the same time, such as beta-blockers, under the guidance of doctors, which can achieve a lowering effect on heart rate.