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Dr. Andrew Rynne

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High BP with high cholesterol. Taking novartis. Why i am getting slow heart rate?

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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

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Posted on Tue, 18 Dec 2012 in Hypertension and Heart Disease
Question: I'am 44 years old. My blood pressure usually high 140-150 / 85 I was subscribed exforge 160/10 by Novartis 2 years ago when I was diagnosed with pb . Occasionally it shoots to 170 very rarely. I started to exercise one hr a day for the past 5 months and I quit the medication my self since I start exercising 5 months ago since my exercise worked well and my diastolic goes low as i realized between 65-70 most of the time. I noteced I have lost 25 pounds and still need to lose more because I'am still overweight 217 and 5.9 tall 176 cm approximately . My pb is controlled and maintained well, usually it's 130-135 / 70-75 but the average pulse pressure been around 60-65 most of the time and my pulse rate around 60 most of the time, some time go to 56 although I used to have heart pulse rate of 80 s and 90 s before I started the daily exercise few months back. My doctor recently put 24 hr pb monitor and the pulse pressure average were 56 and pb is ok. He also did stress test and was fine, echo fine, I have little high cholesterol. Should I be worry for the slow heart rate and my big pulse pressure differences which some time reach mid 70s ?
Regards
XXXXXXX
doctor
Answered by Dr. Anantharamakrishnan 1 hour later
Hi friend,
Welcome to Health Care Magic

Anxiety (Panic) and Obesity could cause high BP.
Exercise, Weight reduction and Anxiolytic drugs (Ativan) reduce the pressure.

     Don’t worry – No need for concern about the pulse pressure. If the ECHOcardiography and TMT (Exercise ECG) are normal, heart disease is unlikely to be responsible. It is from increased volume of pumping from exercise and overweight. There is no basic problem of the heart now and in the future too, in XXXXXXX Allah.
     The heart rate is a bit low. No need to anything. Just observe. Repeat the ambulatory monitoring (Holter) after one year – earlier, if symptomatic.

Allergy to Penicillin before is unlikely to have disappeared now.

Reduce your weight further / Keep your cholesterol lower

Take care
Salaamthak
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan 53 minutes later
Hi doctor
One time my bp was 160 over 70 difference of 90 ( pulse pressure) but did not last long then it was back to normal and I guess this could be the cause Of panic or anxiety.Usually pulse pressure 65 or even 70 , should I be worry?
Is there any medication to increase only the diastolic or medication that lower only the systolic so with time my arteries would not be damaged or Steffens.
ECHOcardiography and TMT (Exercise ECG) are normal.I did 2 treadmill tests in 2 months apart , all normal but the 1st stress test showed exaggerated bp 200/70 after aproxemetly 6 or 7 minutes of test but the second one days back was normal.
My only concern is I feel my pulse going slow and when I check sure enough it is 57 or 59 but most of the time it's 60 and above while resting. Is this ok? And what should I do about it? And one thing worth mentioning is each time my diastolic is low or in another word when my pulse pressure is high I find the pulse rate low as well.
What is your recommendation.
Thank in advance.
God bless you.


doctor
Answered by Dr. Anantharamakrishnan 33 minutes later
Hi

Transient elevation is from stress and no need to worry.
Both volume and arterial stiffness contribute to the raise.

It is common for exaggerated BP response to occur from anxiety in first test.
It is blunted by regular exercise and repeat test.

When the rate is slow, there is more time for the ventricles to fill more and pump more – Systolic is up, Diastolic is down and the pulse pressure wider. Normal and expected.

There is no specific treatment approved to avoid arterial thickening.
Folic acid / Anti-oxidants are sometimes given – not proved definitely.
General measures help – weight a bit less than normal range / Low cholesterol – LDL (100 or less - 70 is ideal) and high HDL (no drugs / life style changes) / no smoking

Holter monitoring later will help to analyse the rate.

Regards
All the best

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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