Blood Pressure Pills And Slow Heart Beat

[tomahawk]

I have gotten very good advice here from Sheryl and others so I will try again. Three years ago I was in hospital here from high blood pressure and tachycardia (fast heart beat). Now I take 25 mg prenolol 2x a day and now my heartbeat is very slow, often 40 bpm. I have done 30-60 minutes aerobic exercise almost every day for last 3 years and lost 20 kgs. I also have not had alcohol in over 2 years and do not smoke.I am 57 years old. My 2 daughters are nurses and say my heart is too slow and I should cut down medication. My doctor here says heart rate no problem because I exercise a lot and these pills slow heart rate down and since I seem okay otherwise I should keep taking pills. My blood pressure is good sometimes and sometimes it is not. I have been to 2 doctors here and 3 back home and every one changes medication. If anyone has advice or experience I would greatly appreciate it. Thank you.

[Sheryl]

The medication you are on does cause a slowing of the heart rate but 40 is a bit extreme. Are you sure you are counting for a full 60 seconds? With slow rates it makes quite a difference.

And have you had a recent EKG? Just to confirm that it is only what is called "sinus bradycardia" and not any type of heart block.

The type of BP medication you are on is called a beta blocker. Used to be a common first line drug for hypertension but recent research has cast it iun a less favorable light. Between that fact, the very slow rate and that you indicate your BP is not always so well controlled, you might ask your doctor if there is any medical reason why you cannot switch to either an ACE inhibitor or an Angiotensin II inhibitor.

If you go with the former, use enalapril and if the latter, losartan as both of these have generic equivalents made locally, don't let them saddle you with newer drugs that are virtually the same but under patent and thus expensive.

[zzdocxx]

Yeah I wonder what type and how fast your tachycardia was.

40 would usually be considered too slow.

Are you having any symptoms such as being light-headed when you stand up, that sort of thing?

Sounds like they are already playing around with you medications, but just haven't found the right combination yet.

Maybe a bit closer medical management ie trips to the doctor for a while till you get this straightened out.

Are you seeing a cardiologist?

[tomahawk]

Thank you very much Sheryll and zzdocxx. To answer questions I have been to cardiologists and had numerous ekg tests which they say show I have some kind of tachycardia which I cannot pronounce but is some kind of electrical condition in ventricle. My heart rate before I started taking pills was often about 86-90 but on day I went to hospital was over 230 bpm. I do take my pulse rate for full minute as doctor said same thing about doing this. Reason doctor gave me beta blocker was he said it was to slow heart rate as well as for blood pressure. He said if I did not take beta blocker I should have ablation operation, but doctor in US said he would not advise I do this.

[tomahawk]

zzdocxx I forgot to answer other question but I did used to get dizzy when standing up fast but doctor cut down medication by 50 per cent and no longer have this problem. Only symptom maybe from pills now is sometimes very tired but I also do not get very much sleep so I do not know if this effect of pills or insomnia.

[ktamp]

I was a cardiac nurse in the states. As long as you are not getting dizzy or lightheaded, your pulse rate is perfectly fine. You should be treated by your symptoms, not by your pulse rate. From what you have described, it sounds like you tolerate the heart rate fine. However i agree with sheryl that if your bp is not controlled, then it may be time to consider another medication.

[tomahawk]

Thank you ktamp and everyone. I will take advice and keep taking pills and also go back to heart doctor.

[ignoramus]

Had the good fortune to be in Thailand recently and caught a cable show which noted that watermelon was good for those with BP. Just the place for watermelon is Thailand, at 10 bht for a decent sized slice. Thanks to one and all, I said to meself.

[zzdocxx]

Tomahawk I am pretty sure you are going to do well, you have done such a thorough job of answering the questions.

At this point, purely from an academic interest, when you are reminded of the exact name of the arrhythmia you had, I hope you'll post it.

230bpm, that's scary fast! BTW what type of symptoms did you have while that was going on? Just curious, I mean apart from your heart racing, were you lightheaded, perspiring, nauseated, etc etc. (?)

Thanks!

[tomahawk]

Thanks again. I will be sure to get some watermelon. I never knew it helps blood pressure but I love it so why not? I have been drinking chrysanthemum tea and cocoa a lot as these are good too, they say. I wish I could remember what doctor called condition zzdocxx but I cannot except it was some kind of ventricular tachycardia. I was playing badminton with lttle kid, not very strenuous game, and I actually felt my heart beating fast in my chest. otherwise I did not feel any symptoms such as short of breath, chest pains etc. Although I have had heart palpitations for years, this is first time it had ever been so fast.

[PMNL]

Is it something like Supraventricular Tachycardia ( STV)?

[tomahawk]

Yes thank you PMNL that is what it is.

[zzdocxx]

Well SVT, if there is what they call a "focus" or basically an "ectopic" pacemaker, ie a bit of tissue that is acting like a freelance pacemaker, then they could go in and do an "ablation", which means to destroy that little bit of tissue that is the ectopic focus or pacemaker. Ectopic meaning it is not in the right place, it is a bit of pacing-type tissue which is somewhere that it shouldn't be.

OK now that I have made that clear as mud, to ablate that ectopic pacer is somewhat of a high-tech proposition usually involving a cardiologist who specializes in "electrophysiology" and or interventional cardiology.

I'd want to make sure I was in very competent hands to have that done if it were me.

Having said all that, if the ablation works just fine, then you are pretty much home free, no need to worry about it or even taking the meds, as far as I know (and I am an MD in the US).

Good luck!

Edited November 2, 2010 by zzdocxx

[tomahawk]

Thank you very much zzdocxx. I plan to someday get this ablation if I have the money, which I do not right now and also no insurance. You explained it much better than eithr doctor here or in US. One thing doctor in US told me is that he thought Thailand doctor was too quick to recomment the ablation. The dr. here made it sound as simple as pulling ttoth out, but the doctor in US said as you did that is a bit more serious than this and their should be more tests first.