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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could High Bp With Rapid Heart Rate Suggest In Elderly?

I am 84 years old take medication for high blood pressure...no other meds....every few months my heart feels like it is racing..and ...a strange feeling kind of comes up under and around my heart. Heart rate is at 90 a minute. I then Take a extra 1/2 a tab of my mediceine...heart rate then stabilized in about an hour. Whole experience leaves me very tired for a couple of days! Then fine again for another few months. Any help you can offer would be appreciated. Thank you!
Wed, 4 Nov 2015
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Cardiologist 's  Response
Hello. Thank you for your question and welcome to HCM. I understand your concern.

I will start my answer by saying that the normal heart rate, standardized for the population worldwide is 60-100 heart beats per minute. Now, a heart rate of 90 beats per minute is not very high. However, it remains to be understood if this "jumping" of heart rate is regular or irregular rhythm. Therefore, I would recommend an EKG at the moment when this happens, which is not very suitable, since to the time you arrive in a healthcare facility, where EKG is done, it may have passed as an episodes. The remaining option is that you wear a 24-hour rhythm monitor, to assess if these are "attacks" with a regular or irregular heart rate. Nevertheless, the fact that an extra half tablet of your medication helps your general condition, then you should discuss with your cardiologist regarding the modification of heart rate and blood pressure-lowering medication. In an elderly, there is often a significant replacement of the normal, functional, sinus node tissue (natural pacemaker of the heart) with an abnormal, non-functional, fibrotic tissue, hence the problems in rhythm and conduction systems. Before further speculating about this heart rate, I would stress again that you should wear the monitor, and then discuss your cardiology for the treatment strategy you are to follow.

I hope this was of help. Wish you a good health.

Best regards,
Dr. Meriton
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What Could High Bp With Rapid Heart Rate Suggest In Elderly?

Hello. Thank you for your question and welcome to HCM. I understand your concern. I will start my answer by saying that the normal heart rate, standardized for the population worldwide is 60-100 heart beats per minute. Now, a heart rate of 90 beats per minute is not very high. However, it remains to be understood if this jumping of heart rate is regular or irregular rhythm. Therefore, I would recommend an EKG at the moment when this happens, which is not very suitable, since to the time you arrive in a healthcare facility, where EKG is done, it may have passed as an episodes. The remaining option is that you wear a 24-hour rhythm monitor, to assess if these are attacks with a regular or irregular heart rate. Nevertheless, the fact that an extra half tablet of your medication helps your general condition, then you should discuss with your cardiologist regarding the modification of heart rate and blood pressure-lowering medication. In an elderly, there is often a significant replacement of the normal, functional, sinus node tissue (natural pacemaker of the heart) with an abnormal, non-functional, fibrotic tissue, hence the problems in rhythm and conduction systems. Before further speculating about this heart rate, I would stress again that you should wear the monitor, and then discuss your cardiology for the treatment strategy you are to follow. I hope this was of help. Wish you a good health. Best regards, Dr. Meriton