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What causes low resting heart rate inspite of being on Bisoprolol?

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Posted on Sat, 16 May 2015
Question: My average resting heart rate has typically been in the low 60's and during the last month my Dr. put me on a low dose beta blocker (2.5mg Brisopropolol) for mild hypertension (eg white coat hypertension). I continued to monitor my blood pressure and heart rate at home and noticed my resting heart rate has been on average in the lower-mid 50's - with some readings in the upper 40's. I don't seem to have any issues other than I'm concerned that it's too low?? My Dr. said not to be too concerned about that but he did cut my dose in half to 1.25mg Bisopropolol. Overall I feel pretty good, but is this too low?
doctor
Answered by Dr. Lilit Baghdasaryan (42 minutes later)
Brief Answer:
Treatment should be revised if heart rate remains slow

Detailed Answer:
Dear Sir,

If you have baseline resting slow heart rate, other medications, which don't reduce heart rate, can be preferred over beta blockers (Bisoprolol).

Actually heart rate below 50 is not desirable in active and young people. But if you don't have weakness, dizziness, it is OK.

I would advise you to take the medication, if your heart rate remains slow, it will be better to discuss with your doctor the possibility of change or withdrawal of Bisoprolol.
I think your cardiovascular risks should be evaluated, and in case of low risk, there is no need of treatment if you have documented high blood pressure only once. In this case follow-up is needed.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (14 minutes later)
Thank you for the response. I'm a little confused though regarding the heart rate concern. I've read other responses where it seems to be perfectly acceptable to have a heart rate in the 50's or perhaps in the upper 40's. I do exercise on a regular basis and so I would expect my average heart rate to remain low (55-65) even if my Dr. has me stop taking this medication since it's such a low dose. Is it okay to continue with the medication as long as my heart rate remains in the 50's?
doctor
Answered by Dr. Lilit Baghdasaryan (8 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

Heart rate of upper 40's and 50's can be acceptable, especially in trained people.
Actually there is no sense to prescribe beta blocker in this case, if a person already has slow heart rate, unless if he/she develops high heart rates very easily.
If you have fast heart rates with high blood pressure with a little stress, you can continue beta blocker. It will prevent tachycardia, thus high blood pressure.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (32 minutes later)
Ok thank you. I believe my Dr. wanted to try a beta blocker to see if he can lower my systolic pressure primarily. My heart rate would also increase substantially in certain stressful situations and it has helped with keeping those two things in check. However, because I generally have a lower resting heart rate in non-stressful situations it's caused me some concern which is why I was seeking a second opinion. So based on this information and as long as my resting heart rate doesn't drop into the 40's on a consistent basis I should be okay to continue the treatment my Dr. prescribed?
doctor
Answered by Dr. Lilit Baghdasaryan (4 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

As you are doing fine, have no complaints related to slow heart rate, you can continue beta blocker treatment.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (21 minutes later)
One last question: can having a lower heart rate as I do lead to heart failure or other long-term issues? I know beta blockers are typically a long-term solution and so I just wanted to be sure I'm not damaging my heart by taking it. Thanks.
doctor
Answered by Dr. Lilit Baghdasaryan (3 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

It can't lead to heart failure.
If you have no complaints, you shouldn't be concerned at all.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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What causes low resting heart rate inspite of being on Bisoprolol?

Brief Answer: Treatment should be revised if heart rate remains slow Detailed Answer: Dear Sir, If you have baseline resting slow heart rate, other medications, which don't reduce heart rate, can be preferred over beta blockers (Bisoprolol). Actually heart rate below 50 is not desirable in active and young people. But if you don't have weakness, dizziness, it is OK. I would advise you to take the medication, if your heart rate remains slow, it will be better to discuss with your doctor the possibility of change or withdrawal of Bisoprolol. I think your cardiovascular risks should be evaluated, and in case of low risk, there is no need of treatment if you have documented high blood pressure only once. In this case follow-up is needed. Hope I could help you Wishing you good health In case of further questions don't hesitate to ask Regards,