Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is BP Of 186/115 And A Pulse Rate Of 44 Normal?
Question: I am 62 years old. I am experiencing high blood pressure ( 186/115 ) and at the same time a low heart rate (40-44). My blood pressure fluctuates greatly. I have seen 90/50 up to over 200/115. I am on licinipril and nefedical ( sorry about the spellings). I take it at night. At night and in the morning, my pressure is up. In the afternoon, my blood pressure drops. My heart rate is always low. I feel okay unless my blood pressure drops below 100. I get lethargic and I have vision problems and balance issues. Why is my heart rate so low?
Email is: YYYY@YYYY
Email is: YYYY@YYYY
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your low heart rate is not related to your actual drug.
It is important excluding a possible cardiac conductance disorder underlying your low heart rate.
For this reason I would recommend performing a resting ECG and an ambulatory 24-48 hours ECG monitoring (Holter).
Not rarely sinus node dysfunction (sick sinus syndrome) may be associated with a single sign of sinus bradycardia. That is why, if your Holter reveals an important and persistent sinus bradycardia, even without any obvious cardiac conductance disturbance, such as sino-atrial or atrio-ventricular block, it would be necessary to follow a cardiac stress test in order to investigate your chronotropic competence (to see if your heart rate increases proportionally with physical strain).
Regarding your blood pressure values, they are really fluctuating during the day and some changes in your actual anti-hypertensive therapy need to be done.
What are the actual dose of lisinopril and nifedipine that you are actually taking?
As your blood pressure fluctuates during a day-night period, it would be to necessary to cover those high blood pressure windows of time with long acting anti-hypertensive drugs, probably taking nifedipine XL twice a day (morning and night) or switching to a long acting calcium channel blocker (such as amlodipine, lercanidipine or felodipine) would be more appropriate.
Another point to consider would be adding hydrochlorothyazide to your actual therapy.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Feel free to ask me again whenever you need!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your low heart rate is not related to your actual drug.
It is important excluding a possible cardiac conductance disorder underlying your low heart rate.
For this reason I would recommend performing a resting ECG and an ambulatory 24-48 hours ECG monitoring (Holter).
Not rarely sinus node dysfunction (sick sinus syndrome) may be associated with a single sign of sinus bradycardia. That is why, if your Holter reveals an important and persistent sinus bradycardia, even without any obvious cardiac conductance disturbance, such as sino-atrial or atrio-ventricular block, it would be necessary to follow a cardiac stress test in order to investigate your chronotropic competence (to see if your heart rate increases proportionally with physical strain).
Regarding your blood pressure values, they are really fluctuating during the day and some changes in your actual anti-hypertensive therapy need to be done.
What are the actual dose of lisinopril and nifedipine that you are actually taking?
As your blood pressure fluctuates during a day-night period, it would be to necessary to cover those high blood pressure windows of time with long acting anti-hypertensive drugs, probably taking nifedipine XL twice a day (morning and night) or switching to a long acting calcium channel blocker (such as amlodipine, lercanidipine or felodipine) would be more appropriate.
Another point to consider would be adding hydrochlorothyazide to your actual therapy.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Feel free to ask me again whenever you need!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
