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What Causes High Pulse Rate?

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Posted on Thu, 5 Feb 2015
Question: bLOOD PRESSURE NORMAL. 114/76 OR 124/80. But pulse always high. Even 93 when first wake up in morning. Sometimes rises to 105-117. However, no sweating or chest pain. Have Type II diabetes also. Why is pulse so high? Regular doctor seen in December 2014. ( Family practice.) Has no real answer.
doctor
Answered by Dr. Ronald Schubert (1 hour later)
Brief Answer:
fast heart rate due to blood pressure medications

Detailed Answer:
Thanks for contacting HCM with your health care concerns.

You are concerned about your blood pressure and high heart rate. Your current blood pressure is actually very good. We want diabetics to have blood pressures systolic in the low one hundreds. But what is of concern is the high pulse rate. This is because of your blood pressure medications. You are taking lisinopril and verapamil which causes vasodilation. This vasodilation reduces the pressure in your body but it also reduce the resistance making your heart having to work faster to maintain your current blood pressure. If you were my patient I would recommend stopping the verapamil and switching you to a beta blocker. The beta blocker will slow down your heart rate and maintain your blood pressure too.

To also help maintain good blood pressure eat a low sodium diet, exercise regularly and loss weight if over weight.

Please discuss this with your primary care doctor and see if they agree with my recommendations.

in summary
1. blood pressure is at goal
2. Elevated pulse rate secondary to low vascular resistance
3. Discontinue verapamil and substitute Beta Blocker
4. Low sodium diet, exercise and loss weight if over weight

I hope I answered your question. Please contact HCM again with your health care concerns or questions
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ronald Schubert (18 hours later)
Forgot to mention that I also have some kidney impairment due to diabetes. eGFR (glomerular filtration rate) was 48 at latest blood test in December 2014. Think level below 60 is significant reduced function. Could this have anything to do with elevated pulse?
doctor
Answered by Dr. Ronald Schubert (13 minutes later)
Brief Answer:
Renal impairment not causing high pulse

Detailed Answer:
Thanks for returning to HCM with your health care concerns

I assumed already that you had renal impairment as you are a diabetic and on lisinopril. Lisinopril is used in patients with renal impairment and it is essential to continue with the lisinopril.

Your high pulse rate is really due to the medication verapamil causing vasodilation and hence reduced vascular resistance. Please discuss this with your doctor and see if he agrees with me.

I hope I answered your question. Please contact HCM again with your health care concerns or questions
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
Dr.
Dr. Ronald Schubert

General & Family Physician

Practicing since :1984

Answered : 2407 Questions

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What Causes High Pulse Rate?

Brief Answer: fast heart rate due to blood pressure medications Detailed Answer: Thanks for contacting HCM with your health care concerns. You are concerned about your blood pressure and high heart rate. Your current blood pressure is actually very good. We want diabetics to have blood pressures systolic in the low one hundreds. But what is of concern is the high pulse rate. This is because of your blood pressure medications. You are taking lisinopril and verapamil which causes vasodilation. This vasodilation reduces the pressure in your body but it also reduce the resistance making your heart having to work faster to maintain your current blood pressure. If you were my patient I would recommend stopping the verapamil and switching you to a beta blocker. The beta blocker will slow down your heart rate and maintain your blood pressure too. To also help maintain good blood pressure eat a low sodium diet, exercise regularly and loss weight if over weight. Please discuss this with your primary care doctor and see if they agree with my recommendations. in summary 1. blood pressure is at goal 2. Elevated pulse rate secondary to low vascular resistance 3. Discontinue verapamil and substitute Beta Blocker 4. Low sodium diet, exercise and loss weight if over weight I hope I answered your question. Please contact HCM again with your health care concerns or questions