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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should He Be Concerned About The Heartbeats Of 50 And Below?

My Husband has been battling high blood pressure since end of December til now he had Eye surgery in January and again in March and his blood pressure is mostly up! His dr said to be concerned if his pulse goes into the forties! He has like 5 or 6 reads of a 40 something pulse but not consistently usually goes back up in the 50! Should he be concerned and what can he do he takes methaldopa 500 mg 2 tables twice a day he is also taking a beta blocker 1 tab 1 a day and verapamil 1 tablet twice a day! He is also diabetic and takes insulin and sugar medicine
Wed, 5 Aug 2015
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Cardiologist,  's  Response
Hello, madame. Thank your for your question and welcome to HCM. I understand your concern.

I would like to explain to you that some of the drug classes that are used to lower the blood pressure, such as most beta-blockers and calcium channel blockers (verapamil and diltiazem) also lower the heart rate. If I was treating your husband, I would definitively not combine a beta-blocker with verapamil as this combination in counterindicated and very dangerous. In some cases, it can cause the heart to stop. Therefore, I recommend that you should immediately consult your curing cardiologist to take one of these classes off the blood pressure-lowering strategy. After all, there are a lot of other drugs that can be used in this setting, if not counterindicated by any co-existing kidney disease. Angiotensinogen converting enzyme inhibitor (ACE-I: captopril, enalapril, ramipril) drugs, angiotensin receptor blocker (ARB: losartan, olmesartan, eprosartan) drugs or diuretic (hydrochlorthiazid, furosemide) drugs, can be added to his regimen. But, I strongly recommend that either the beta-blocker or verapamil should be stopped, and then monitor the heart rate.

I hope I was helpful. Best regards.
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Should He Be Concerned About The Heartbeats Of 50 And Below?

Hello, madame. Thank your for your question and welcome to HCM. I understand your concern. I would like to explain to you that some of the drug classes that are used to lower the blood pressure, such as most beta-blockers and calcium channel blockers (verapamil and diltiazem) also lower the heart rate. If I was treating your husband, I would definitively not combine a beta-blocker with verapamil as this combination in counterindicated and very dangerous. In some cases, it can cause the heart to stop. Therefore, I recommend that you should immediately consult your curing cardiologist to take one of these classes off the blood pressure-lowering strategy. After all, there are a lot of other drugs that can be used in this setting, if not counterindicated by any co-existing kidney disease. Angiotensinogen converting enzyme inhibitor (ACE-I: captopril, enalapril, ramipril) drugs, angiotensin receptor blocker (ARB: losartan, olmesartan, eprosartan) drugs or diuretic (hydrochlorthiazid, furosemide) drugs, can be added to his regimen. But, I strongly recommend that either the beta-blocker or verapamil should be stopped, and then monitor the heart rate. I hope I was helpful. Best regards.