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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do Persistent High BP And Low Pulse In A Heart Patient Suggest?

My mother has heart failure, diabetes, CKD, hypertension (was once diagnosed with malignant hypertension). So it s not unusual for her BP to be 205/73. But lately, her pulse rate that shows with her BP on her machine has had her pulse in the low 40s. Is there anything she can do other than just call her doctor? What does this change mean?
posted on Sun, 10 May 2015
Twitter Sun, 24 May 2015 Answered on
Twitter Mon, 25 May 2015 Last reviewed on
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General & Family Physician,  's  Response
Thank you for asking on HCM.

Your mother is suffering from heart failure, diabetes, hypertension, Chronic Kidney Disease and also has a medical history for malignant hypertension.

Normal pulse ranges from 60-100 bpm.

Based on her actual illnesses, her low pulse may be due to progession of heart failure, drugs that she uses (i.e betablockers used in hypertension such as Atenolol decreases heartbeats, but also some other type of drugs may cause this, so if so changes in therapy should be done, i.e stop Atenolol and start Furosemide/Spironolactone, but this should be done only after consulting with her physician), CKD causes electrolytes disbalance, that may decreases heartbeats. Diabetes also may causes troubles in heart and some conditions with reduced heart rate (i.e heart block, etc), metabolic issues.

A general check up to evaluate primarily the possible cause is required:
- Complete blood count
- Glycemia
- ECG
- Electrolytes
- Creatinemia
- BUN
- Lipids profile
- Arterial blood gas
- Urine ketones

Some specific tests may be required from specialists:
- heart ultrasound
- eGFR
- HbA1c

First I recommend that your mother should see her cardiologist, then a consult with other specialists may be required.

Wish good health for you and your mother.



Dr. Elton
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What Do Persistent High BP And Low Pulse In A Heart Patient Suggest?

Thank you for asking on HCM. Your mother is suffering from heart failure, diabetes, hypertension, Chronic Kidney Disease and also has a medical history for malignant hypertension. Normal pulse ranges from 60-100 bpm. Based on her actual illnesses, her low pulse may be due to progession of heart failure, drugs that she uses (i.e betablockers used in hypertension such as Atenolol decreases heartbeats, but also some other type of drugs may cause this, so if so changes in therapy should be done, i.e stop Atenolol and start Furosemide/Spironolactone, but this should be done only after consulting with her physician), CKD causes electrolytes disbalance, that may decreases heartbeats. Diabetes also may causes troubles in heart and some conditions with reduced heart rate (i.e heart block, etc), metabolic issues. A general check up to evaluate primarily the possible cause is required: - Complete blood count - Glycemia - ECG - Electrolytes - Creatinemia - BUN - Lipids profile - Arterial blood gas - Urine ketones Some specific tests may be required from specialists: - heart ultrasound - eGFR - HbA1c First I recommend that your mother should see her cardiologist, then a consult with other specialists may be required. Wish good health for you and your mother. Dr. Elton