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Arrhythmia & Palpitations

Question: I've experienced heart palpations before, but now I'm pregnant and have been having them more frequently. When I have them I get light headed, experience chest and throat pain and start sweating. They last anywhere from 5 to 15 minutes and I've had three in the past month. My doctor said not to worry, but to see him if they won't stop. Should I be concerned?

Answer: If these symptoms are bothering you, which it sounds as if they do, I would suggest you see your physician for an evaluation. -JRS

Question: I have mitral valve prolapse which I seem to manage fairly well with rescue remedy for the panic though I've been to the ER 5 times in the last year... do you think prempro might be causing my depression and or palpitations? I refuse to take atenolol it gave me asthma and depression and calcium channel blockers gave me chronic slowness. Also I had a TIA in January and am wondering about this prempro. Thanks

Answer: If you had your depression and palpitations prior to taking PremPro, the answer is no. It does not sound as if atenolol is a good drug for you because of the depression and asthma. However, calcium channel blockers (CCB) should help....but you complain of "chronic slowness" . There are many CCBs on the market. If one doesn't work, there are others to try. Was your TIA evaluated? What are you wondering about PremPro? Did you think it caused a TIA? If you have been on this drug for more than 2 years, then stopping it due to a TIA is not necessary. However, if you recently started PremPro and then had a TIA, there is a good argument for stopping it. I hope I answered your questions. -JRS

Question: Has there been any evidence or studies that tie panic attacks to premature ventricular contractions?

Answer: Anyone who experiences anxiety/panic has an outflow of stress hormone called adrenalin. This can cause fast heart rates and possibly premature atrial or ventricular beats. -JRS

Question: I am a nursing student looking for information on SVT. I am looking for the actual signs to look for and what is going on with the heart physiologically.

Answer: It is admirable that you are curious about the pathophysiology of SVT, signs and symptoms, and management of SVT. I would advise you to refer to Braunwald's textbook of Heart Disease. It is very interesting reading. Good luck. -JRS

Question: Hi. I'm 23-years-old and have been diagnosed with PAC's. I have had them for 4 years now. I was wondering is it safe to become pregnant with this or is there complications that can occur?

Answer: PACs are not a contraindication for pregnancy. However, if you are taking medication for the PACs, please discuss this with your doctor/gynecologist before you get pregnant. -JRS

Question: I was placed on Rhymol about a year ago for a very fast heart rate (prompting a visit to the ER in an ambulance) and since that time have felt light headed from time to time. Last Friday I had several episodes and when checking by blood pressure it was 106 systolic. Can Rhymol lower your blood pressure so that you could have light-headedness? Is there another drug that would be effective with fewer side effects, i.e. Tiazac?

Answer: There are multiple medications for fast heart rates...finding the "right one" is tricky. You need to discuss your lightheadedness and blood pressure with the cardiologist who put you on Rhythmol. Then a decision can be made if this is the best drug for you. -JRS

Question: I am a 26-year-old female who was diagnosed with paroxysmal atrial tachychardia June of 2001. I had had an anxiety attack from March 8th to March 10th of 2001. I am 5'2" and 190lbs. I have a large bone structure, so I am not petite in any way, except for my height. I take 50 Mg of Zoloft and Orthotricyclene 28 each morning. Before I started taking the Zoloft, I weighed 155lbs. I have 7 questions. First: What is the exact cause(s) of paroxysmal atrial tachychardia? Second: Which would come first, PAT, or anxiety? Third: What are the ways of dealing with PAT? Fourth: What is the procedure for ablation? Fifth: Is there any complications with the ablation to be concerned about? Sixth: Is there any way of taking the weight off by changing my Zoloft to another medication? Seventh: Will the anxiety subside once the ablation is preformed? Thank you for your time.

Answers: Question #1: There are many causes for paroxysmal atrial tachycardia (PAT) Please refer to all of the previous questions and responses regarding palpitations. Question #2: I don't know. You need to ask yourself that question. Question #3: Please refer to #1. Question #4: Ablation is a procedure in which the abnormal electrical tissue in the heart, which causes the erratic heart beat, is eliminated by a radio frequency current coursed through the tissue. It is usually done by threading small catheters into the right side of the heart via a vein in the groin. The electrical tissue in the heart is "mapped". When the abnormal tissue is located it can be eliminated by radio frequency catheter ablation. Question #5: There is a small risk of infection, bleeding, damage to the heart valves, perforation of the heart, inflammation around the heart, or the need for a pacemaker. Question #6: Changing medication may not be effective in weight loss. The only method of weight loss that I suggest is decreasing the number of calories you eat and exercising. Question #7: If the palpitations are causing the anxiety...maybe. However, you may need to further investigate other possible causes of anxiety. -JRS

Question: I am a 50-year-old woman with a 20-year history of mitral valve prolapse. During the last 4mos I have been going through a very stressful time with job layoff etc. I have always had palpitations etc. symptoms & taken low dose beta-blockers. Lately, however, I was feeling extremely tense like in waves. I noticed if I took 1 or 2 Excedrin migraine tablets a day I felt much better. I am no longer drinking any coffee or other caffeine. I still was feeling very anxious & saw my GYN. She felt I am probably in menopause & prescribed low dose birth control. About a week after starting this I started having terrible palpitations & skipped beats. After a couple of days of this I stopped the birth control & it got better. Then yesterday at about day 15 of my cycle it started up again with the palpitations. Especially bad when I first stand up in the AM & move around or change positions. I am pretty good while sitting. My Dr. gave me an EKG & listened last time to my heart. Said was OK. I don't know what this position thing is all about. I know this is very long, but could you please give me a clue. I am currently on 100Mg Toprol. Increased from 50mg atenolol about 2mos ago. Like I said maybe it is hormones due to menopause, or the anxiety of a buyout and new job at this time. I also have a 9 yr old child. Thanks a Lot.

Answer: All of the things you stated can cause palpitations. However, Excedrin Migraine has caffeine in it... and, as you are aware caffeine can increase palpitations. For unknown reasons, during perimenopause, palpitations can become more pronounced. -JRS

Question: Please tell me what you think continued irregular heart beating, elevated white blood count and low (2.9) potassium levels are symptoms of. I will be seeing my doctor for an explanation as well.

Answer: The first question that needs to be posed is: why is your potassium so low??? Low potassium can cause erratic heartbeats. Are you taking diuretics? Do you have high blood pressure? Are your WBCs high due to infection or is there a more serious cause? These problems need to be evaluated ASAP. Good luck, -JRS

Question: I've been having heart palpations since 1995, I've had many EKG's and they come out normal. I've worn the 24-holter monitor for 24 and 48 hours as well and they came out normal. I'm having more episodes recently and last night I was sitting eating dinner with my husband and I had a dizzy spell which almost knocked me out. Also, I have been experiencing the chills as well for many years. Do you have any suggestions? Could these three issues be related? I'm 33 years old. I have a long history of allergies and asthma. I think my doctor thinks I'm crazy. I just had a CBC/diff done and all numbers came back normal. Thanks.

Answer: Did you have palpitations when you wore the Holter monitor? If you didn't the test was not diagnostic. Did you feel palpitations when you became dizzy? I cannot determine from the information I have what is causing your symptoms. Sorry, -JRS

Question: I have started having rapid heart rate. I am not taking any medications (prescription or over-the-counter). In just a few minutes my heart rate can range from 98 to 158 then back down to 121 with no changes in action, this does happen sometimes when I am lying in bed. I also often times but not always, have the feeling that something heavy is laying on my chest. I have been to a Cardiologist and was hospitalized once for testing. Always, the results show that I am not and have not had a heart attack. What is the explanation!!

Answer: Rapid heartbeats can be annoying. There are many things that can cause rapid heartbeats (tachypalpitations). You stated that you are not taking any over-the-counter or prescription drugs. Are you taking any illicit drugs (amphetamines, stimulants) or ephedra - located in some food supplements? Caffeine and chocolate can cause rapid heartbeats also. Thyroid functions tests need to be done to determine if an abnormality in your thyroid gland could be causing these rapid heartbeats. I would assume that the blood tests were already done. Once the above causes of rapid heartbeats are eliminated, other steps could be taken. If the rapid heartbeats become too annoying or cause other symptoms (e.g. fainting) you could be evaluated by an electrophysiologist (a heart doctor who specializes in disturbances in heart rhythms). Good luck, -JRS

Question: I am 35 years old, with a family history of heart disease. In April, I felt as though I had a lump in my throat, and was subsequently diagnosed with reflux. The pump inhibitor medicines they gave me did not work, and addition to this I noticed heart palpatations. I dismissed the connection, but also got off the medicines, and had been trying to make due without-hence the palpitations stopped. The discomfort was so great that I again tried the medicine weeks later-Aciphex to be precise-, and once again the palpitations returned. THIS time they will not go away. For three weeks now, I have been fighting this. In addition, I have left chest pain, dizziness, lightheadedness, heaviness in my lower legs, and tingling all over. With my family history of heart disease, you can imagine my concern. I was told that I did not need an EKG because I had one about a year ago, and it was normal. I wore a monitor for 24 hours which showed an abnormal heartbeat----"but don't worry about it." They put me on atenolol. I already have low blood pressure, and felt worse! Now, I am on acebutenolol-third day-, and of course see no improvement. I am told this medicine may take weeks to show improvement. They actually had me scheduled for a recheck in October-I changed it to next month, but wonder if I should demand more tests now. I teach aerobics, and am considering quitting because I am so lightheaded during my classes. The nurse said that some people live with this forever, and it is really more of a nuisance than anything. I have a news flash for her...it is MORE than a nuisance, my quality of life has been greatly reduced in just three weeks, and I am about to quit the job I love and have been doing for over 15 years! Stress?? YES, anyone would have stress if their heart skipped a beat 24 hours a day, and each time it happens you feel the throb!! I do not recall being stressed BEFORE this happened. Thanks.

Answer: I am sure that your symptoms concern you. You sound as if you are at your wits end. Most irregular / skipped heart beats are not dangerous.....but they are very annoying. Some people describe a feeling of fullness in their throats when they occur. This could, in fact, be diagnosed as reflux. Beta-blockers such as acebutolol (Sectral) which you have been prescribed needs to be started at a low dose and increased gradually. Keep in mind that stress can actually increase the number of "skipped" beats. Other things that can cause them are caffeine, chocolate, stimulants (ephedra in diet/food aids), decongestants and decongestant nasal sprays. I would hope that you don't smoke (given your committment to aerobics).....but if you do, with your family history of heart disease, a stress echocardiogram should probably be done. Good luck.......exercise usually decreases the "skipped" heart beats. -JRS

Question: I am 32 yo female who has experienced PAC's prior to my monthly menstrual cycle for as long as I can remember. It gets worse when I am under stress, but as soon as my period comes, they pass. Also, when I was pregnant they were frequent at the end of my pregnancy. Do you recommend any vitamin that may alleviate theses PAC's. I have a total workup/stress test, etc. that indeed confirmed that they are PAC's. Is there a reason they occur prior to one's period? Is something low at that time that makes them more frequent?

Answer: Frequently women complain about palpitations prior to their menses. So, fear not, you are not alone. Needless to say, these symptoms can be annoying. The cause is unknown. I am not aware of any vitamin or food supplement that has been shown to eliminate or decrease PACs. Caffeine and chocolate can precipitate palpitations. Medications which are stimulants, such as Sudafed and neosynepherine nose spray, can also cause irregular heart beats. So it would be wise to avoid these things substances. -JRS

Question: Why do people's hearts' rates speed up and slow down?

Answer: Heart rates increase and decrease in order to deliver the appropriate amoun of ocxygen to the tissues of the body. Heart rate speeds up in response to activity, emotions, fever, to name a few reasons. The heart rate slows when less oxygen is needed by the body, such as, during sleep, rest. However, some fast & slow heart rates may be a sign of disease. -JRS

Question: Hi, I am 16 years old. Today is exactly 1 month since I have been having my heart palpitations. I have been in and out of the hospital but they don't know what is wrong with me until today. I went back to the hospital and they told me that I might be having heart palpitations due to my thyroid gland. They came to that conclusion because I took a blood test two months ago when my knees where hurting and something in my throat came up and the doctors called my house and asked did I have a sore throat that day and I didn't and then I haven't heard anything about it until now. I am going back to the hospital tomorrow to do more blood test. But if it were possible would you please explain to me how the thyroid gland is connected to me having palpitations?

Answer: Thank you for this insightful question. The thyroid gland has a great influence on the heart. The hormone the gland produces controls metabolism. Too much of this hormone results in increased heart rate (palpitations), fatigue, irritability and muscle weakness, and weight loss. If not controlled hyperthyroidism can lead to heart complications, especially if you have any underlying heart disease. It is wise to find out the underlying cause of the hyperthyroidism and treat it. -JRS

Question: Another question on palpitations! I am 34 and do have mitral valve prolapse, hashimotos, and recently told I have the anti-body that can turn to Graves. My thyroid has been in check 2.2 TSH for almost a year now. My biggest concern is feeling skipped beats during exercise. I have had extensive work ups, short of an EP study. They don't always occur, but when they do it is usually at higher intensity aerobic exercise. If it is too hot outside and I am running, they appear. I never noticed this until the last couple of years. I have always been an athlete. I also have a very slow heart rate 50 to 55 at rest. But when I start exercising it shoots up quickly to 120. I don't go much over 160 for fear of palpitations. Do some people just experience skipped beats during exercise; do you know of any one? I do feel them at rest but not everyday. I do notice an increase during ovulation and right before my cycle. I miss exercising without fear.

Answer: You stated the palpitations occur when you exercise when it is too hot outside. Perhaps you are dehydrated when they occur. Try drinking a diluted sports drink, such as Gatorade, prior to hot weather exercise. -JRS

Question: My heart has a tendency to skip beats and it causes chest pain that can last all day or only a little while. When it skips I can't breathe and then after it feels as though I need to catch my breath. When my heart skips it speeds up then slows dramatically within 20 beats. What is wrong with me?

Answer: "Skipped heat beats" occur in many people without any heart disease. They are annoying and can cause a sensation of breathlessness. Skipped beats and rapid heartbeats can be caused by stimulants such as caffeine, decongestants, chocolate; anxiety, abnormal thyroid function, and structural heart disease can also cause this problem. You ask is anything wrong with you.... I don't have enough information to answer the question. However, I am concerned that you said the heartbeat dramatically slows down when the skipped beats stop. This should be evaluated by your physician. -JRS

Question: I have what feels like an extra heartbeat or a skipped beat...my echo was normal...but my electrolytes were low...and my cardiologist prescribed potassium since I am on vaseretic 10/15 once a day...but after reading the side effects of potassium...I am afraid to take them...drink orange juice almost everyday.... but recently they started again. Also...I am almost 49...and have noticed that these start a day before.or the day of my period...continue off and on for several days...then begin again at onset of next cycle...also. I have felt these on rarely since I was about 33...and was not too concerned even though they showed up on my ekg when I wasn't feeling it.dr told me this was normal alot of times for people who have high blood pressure...I wore the holt monitor for 24 hr. which picked up a few.then the other night I sent in some readings from the king of hearts monitor...haven't heard from that yet...it scares me and I'm just wondering if you think it would be to my advantage to try the pot. tablets...and how dangerous could this be if my echo is normal...thank you

Answer: It sounds as if the low potassium is causing your abnormal heartbeats. Please take the potassium as prescribed. It would take 8 feet of bananas or a half-gallon of orange juice to get the minimum daily requirement of potassium (and that's a lot of calories!). Often palpitations or skipped heartbeats seem worse prior to menses. The mechanism of this is not fully understood...however, low levels of potassium could make your symptoms worse. -JRS

Question: I am a 28 year old who is currently obese by about 80 lbs but recently have lost 30lbs.I am doing it right and walking and eating better... weight gain was cause by norplant, death in family, depression, anxiety and pregnancies on top... well I have panic disorder and recently have beginning to experience heart palpitations almost daily now...the doctor has done ekg, chest xray, been to hormone doc etc.they most frequently occur after eating a meal and when I am quiet or resting... I feel like I am going to lose my mind as I am always focusing on I am going to die a cardiac death... I am in therapy and I DO TRY NOT TO LET THE PALPS BOTHER ME AS THEY DO SEEM TO PUT ME IN full-blown panic... Do you have any information of heart palpitations and diet like linking it to monosodium glutamate or additives like BHT in food etc.? The last few times, they have been 20 minutes to 1 hour after eating... I hate feeling this way and no one will listen to me... I am told I am healthy for being overweight, low blood pressure, no sugar...very mild elevated cholesterol. I am just looking for answers. Thank you

Answer: There are many women who have asked questions about palpitations. Please refer to any one of the questions and answers in the "Ask the Nurse" file of Q& As. As for your question if monosodium glutamate and bht can cause palpitations...I don't know. But, if you think they are the culprits, eliminate these food additives from your diet. Good luck -JRS

Question: I am a 37 year old woman - I went to my physician because I was having what I thought was heart palpitations and pain on the left side of my chest. She performed an electrocardiogram and discovered Multiple Atrial Premature complexes. I then went to see a male cardiologist who said because I was so young everything should be fine. He then prescribed me on 20mg of Corgard and said come back in a month, only if I did not feel better. Should I be satisfied or concerned??

Answer: Palpitations caused by premature atrial contractions can be very upsetting. So, I understand your concern. However, most palpitations are harmless. They can be caused by excess caffeine, chocolate, stimulants, decongestants, or stress. Other causes of palpitations can be due to thyroid disorders or structural heart disease. These problems can be evaluated through a physical examination, blood work, echocardiogram, or Holter / Event Monitoring (at-home heart monitors). From what you said your cardiologist did not seem too concerned with your palpitations. He gave you Corgard, which is a good medicine for the palpitations. If you are not feeling better in a few weeks, make another appointment. Then other evaluation and treatment options can be explored. Feel better! - JRS

Question: I am an asthmatic and have been prescribed aticand and triamter due to heart palpitations a year and a half ago. I also have had high blood pressure, which seems to be controlled. I am in perimenopause and notice that all things considered, I feel better if I take a multivitamin with B-levels for stress, calcium (1000-1500 mgs daily), magnesium (450mg, vitamin E (400I.U.), fish oil (1000) and flax oil capsules daily. I also take COQ10 and arginine. Are these safe? Do they cut risk of inflammation and heart attack? There is a history of heart problems on my paternal side, whether individuals are fat or thin, and my mother's eldest brother died of a cerebral hemorrhage at 45.

Answer: Palpitations can be quite annoying... and frightening. Too much caffeine (e.g. coffee, tea, cola, chocolate), medicines such as decongestants (taken by mouth or by nose spray) and asthma inhalers, mitral valve regurgitation (leakage) and stress can all contribute to palpitations. If you have not had a complete evaluation already to rule out dangerous causes for your palpitations, then this must be done. If the palpitations make you feel dizzy or lightheaded, you should ask your doctor for an evaluation by an Electrophysiologist as well. An Electrophysiologist is a cardiologist (heart doctor) who specializes in the evaluation and treatment of abnormal heart rhythms and abnormal heartbeats. Use of over-the-counter supplements may react with other medicines you are taking. Check with your doctor or pharmacist. - JRS


Question: When it is suggested to take an "aspirin", should that aspirin be chewed or swallowed?

Answer: It depends on the circumstance for which you are taking the aspirin. It is suggested to chew the aspirin IF you are having chest pain/angina or think that you are having a heart attack. Theoretically, the aspirin will get into your system faster when it is chewed. - JRS

(Unless advised by your practitioner, women should not take a daily aspirin. Aspirin use is not without risk)

Question: I am inquiring if it's safe enough and healthy enough to take an aspirin every day, some say yes some say no, doctors and reports seem to contradict themselves, which is it, safe or not. Also... if a person has high blood pressure, are there any symptoms to indicate so?

Answer: There are usually no symptoms of high blood pressure until it starts to cause kidney damage, strokes, and heart attacks. The jury is still out on the benefit of aspirin in the prevention of first heart attacks. However, there is a decreased risk of experiencing a second heart attack and ischemic (clotting) stroke when a person takes aspirin. Aspirin can cause stomach bleeding, hemorrhagic (bleeding) strokes (especially in people with high blood pressure). This occurs more frequently in the elderly. -JRS


Question: Is there such an illness as asthmatic heart and is it life threatening?

Answer: You asked what is an "asthmatic heart" and is it dangerous. Wheezing due to heart failure/pulmonary edema (an asthmatic heart) is due to fluid "backing up" into the lungs from the left side of the heart. This is serious and needs to be evaluated and treated by a cardiologist. This condition is different from (lung) asthma. Pulmonary (lung) asthma causes wheezing (a sound caused by restricted airways) due to constricted, inflamed, or mucous-filled airways. - JRS

Question: My daughter, aged 15, suffers from asthmatic disease. The doctor initially said that the disease could be healed but through the years, it's getting worse. She has started using an inhaler. She frequently suffers from chest pains and I'm wondering if there's any other medicine available in store. I'm currently based in Italy, Rome. Do you know of specialist doctors in Rome who we can visit?

Answer: You sound concerned about your daughter's asthma. I am sorry to say that I do not know any physicians in Rome. However you do need to find a pulmonologist (lung doctor). Prescription inhalers are not all the same. Some help prevent inflammatory reactions to allergens and some help open constricted airways. There are other medications for asthma beside inhalers. However, these need to be prescribed by a physician. Sometimes just controlling allergies can help asthma. A lung function test needs to be done to determine what type of airway disease your daughter has before specific drugs can be given. Yes, asthma can cause chest pain. -JRS

Blood Pressure Management

Question: Is there a table of blood pressure vs. age both for the systolic and diastolic pressures? Is there a table that links blood pressure to the pulse? This is just for information and I would appreciate your response.

Answer: No on both questions. Blood pressure should be less than 140/90. In diabetics it should be less than 135/80. -JRS

Question: I have very erratic blood pressure readings. They usually follow a pattern with very high readings between 8 a.m. and ll a.m., with readings as high as 210/110. At other times I have low readings with readings as low as 70/50. Most of the time the readings are in normal ranges. The instrument, which I use to take the readings, is accurate. I have Parkinson's and take Sinemet, Requip and Wellbutrin. I am seventy-one years old. My physicians are baffled. Do you have any possible explanation? If you require further information, please advise.

Answer: Ambulatory blood pressure monitoring should be done. This test is done with a calibrated machine over a period of time (24-48 hours). You can keep a diary of your activities during the monitoring period. Then the range of your blood pressures can then be evaluated. -JRS

Question: Hello...what would a healthy blood pressure be after jogging or exercise? I know around 80-120 is a healthy resting ...but mine goes to 190/100 after exercise...is this normal?

Answer: Your peak exercise blood pressure is a bit high. It should be evaluated. Tell your doctor what you told me. An (ordinary) exercise stress test could give more information about your blood pressure response to exercise...and it would be evaluated in a "safe" environment. -JRS

Question: My blood pressure is 170/110. My family doctor has put me on Aticand. Is this blood pressure really high? What is the range for a 39-year-old, 5'0, 132 lb woman?

Answer: Blood pressure should be below 140/90 for ANY adult. -JRS

Question: I am a female 66 years old. I am 50 pounds overweight, have High Blood Pressure (on medications) I have high Cholesterol (on medications) My doctor has recommended a low salt diet (2 grams sodium), how much is that equivalent to? She also wants me on a low fat, low calorie diet. She also said that I should buy water-based Salad Dressing? Do you know of any such dressing, or recipe? Also are there recipes on this site that would address all of the above health problems that I have? Thank you for reading and addressing my problem in advance.

Answer: There are a few recipes on this site (go to newsletter page and link to recipes). I would advise you to buy an American Heart Association cookbook. A two-gram (sodium) salt diet is equivalent to 2000 mg. Read the labels on the foods you eat. The salt content per serving is on the label. Avoid canned or processed foods including luncheon meats, snack foods (especially chips). The cookbook has information on label reading. If you loose some weight and walk every day your blood pressure will decrease. Water-based salad dressings are no oil dressings (every tablespoon of oil is 100 calories!). The flavor comes from vinegar and spices. -JRS

Question: I am 53 female with some problems with blood pressure and my heart. I have had hypertension for 25 years and horrible blood fat problems. Triglycerides 5000 without med. Cholesterol 900 without meds. I am not overweight do not do drugs and am active but shortness of breath and fatigue have really slowed me down. I am on Lopid 600mg 2x daily and Zocor 20 mg once daily Tiazac 240mg daily and Toprol xl 12 and a half mg a day. I also take Accolate for mild asthma estrogen patch 0.025 mg and Previcid 30 mg for gerds. My echocardiogram showed mitral regurgitation moderate, and left ventricular hypertrophy mild concentric. my question is this I take my blood pressure 2xs daily with a very accurate machine and the morning pressure and pulse are always very high, I feel very relaxed when I take it but I don't understand this, pulse is anywhere from 100 to 120 and pressure is 160 over 98 on an average, later in the day it is a lot better why is this, Any help would be mostly appreciated. Thanks for your time.

Answer: Your BP and heart rate are probably elevated because your morning medications have not yet taken effect......or perhaps the tiazac/toprol need to be adjusted. Please keep a log of your blood pressure and heart rate. Share this information with your cardiologist (I hope you have one). This along with your symptoms of shortness of breath and fatigue need to addressed very soon. The shortness of breath could be due to your asthma, mitral regurgitation, or elevated blood pressure...to name a few reasons. Good luck, -JRS

Question: I recently went to the doctor for a check. This time my blood pressure first reading was 160 over 90. Then it was 160 over 80 and the last was 155 over 80. My first thought was I had not eaten since 9:00 a.m.. This was 3:00 p.m. I had just finished a 32oz. coke, plus I was kind of nervous. I had never had a reading like that. She was not real concerned, but wanted me to monitor it for 2 months. I did go to Wal-Mart to have it checked this evening, but I got a couple readings, 145 over 90 and then 150 over 85, so I am really confused and worried. What are your thoughts? My blood pressure is evidently fluctuating, but I dont know why. Given the things I have told you let me know what your think. Thanks.

Answer: Blood pressure varies, so the range of your blood pressure over the period you specified is not uncommon. Yes, you should keep a close watch on your blood pressure...it is a bit too high and may need to be treated if it does not stay below 140/90. Weight loss and daily walks can help decrease blood pressure without medications. -JRS

Question: Every time I have my blood pressure taken it is very low (100/55), but my pulse rate is high. Usually, 88 to 92 beats per minute. It seems to me that this doesn't appear to make sense. Is there a reason for the differences or is this normal. I've always been in great shape. Although, the last two years I have dealt with a pretty severe anemia problem. I was wondering if this could have had anything to do with it and if my heart is at any risk? Thanks!

Answer: Anemia can cause a fast heart rate and low blood pressure. -JRS

Question: Re: Blood Pressure readings ... I've seen numerous sites that describe the procedure for taking blood pressure readings. Most agree that a person should be seated and at rest 3-5 minutes prior to the reading and Women's Heart Foundation indicates that you should initially take pressure in both arms, etc. However, something that SEEMS sensible, I've only seen mentioned once and that is that: for accuracy, BP readings should be taken at least twice in a row, with the readings being taken at least two minutes apart and those readings then averaged to arrive at a more accurate result. I've been told that BP readings taken one right after another (with NO "minutes" in between) will cause the SUBSEQUENT readings to be inaccurate. Can you shed any light on these issues? Thanks. Regards, GAR

Answer: You are correct in all of your statements. Quite a few years ago a study was done. It stated that 95% of the people observed taking blood pressure did it incorrectly. Frightening, isn't it? -JRS

Question: I have high blood pressure and in the early morning it reads about 190/80. I am presently following a doctor's prescription, using Acupril 20 mg. Is there anything further that I can do? I am a female 80 years of age.

Answer: There are many medications that can be added to your Accupril to help control your blood pressure better. Keep a record of your blood pressures 3 x a day for a week and show it to your doctor. -JRS

Question: How serious is a blood pressure of 161/115 and a pulse rate of 118

Answer: It is a serious problem. -JRS

Question: I am a 78-year-old woman taking blood pressure medication. Dr keeps changing it due to shortness of breath. Is their any blood pressure medication I can take that would not cause me shortness of breath? I do have some emphysema, but need to see if blood pressure medication would make this worse.

Answer: Thank you for asking me the most insightful, intelligent question which has been posed to me so far on this FAQ! Blood pressure that is NOT in control can cause shortness of breath. Your physician may be changing your medications for optimum blood pressure control therefore trying to help decrease your shortness of breath. Unfortunately some blood pressure medications may cause increased wheezing and consequent shortness of breath. This can occur when some patients are given beta-blockers, particularly those with asthma/COPD (Chronic Obstructive Pulmonary Disease - also known as emphysema). But keep in mind that this particular category of drugs does not usually cause shortness of breath. There is a lot of trial and error when it comes to prescribing blood pressure medicines.... everyone responds differently to each medication. I would hope that you have undergone an echocardiogram, pulmonary function tests and a stress test with imaging in order to more thoroughly define the causes of your shortness of breath and high blood pressure. If you have any further questions, please feel free to ask. Good luck, -JRS

I am a 42-year-old woman with high blood pressure. I have no way to go to a doctor for this. I walk 2 miles everyday and that hasn't helped. Is there anything else I can do? I eat a low fat, low salt diet. Please help. My blood pressure goes from 150/107 to 170/110.

Answer: Blood pressures at that level are too high...and dangerous. It can lead to stroke or heart attack or kidney damage. See a doctor, please. If you cannot afford one, go to a local clinic. -JRS

Question: I have been going to the same doctor now for about 15 years. When I first visited him I was about 30 and he told me my blood pressure was a little high. He told me to cut back on salt and come back in 30 days for a follow-up visit. With no other advice about changes in diet or exercising, after 30 days he said my pressure was borderline high and prescribed some medication. Over the past 15 years he has changed my medications at least 6 times and he always says my pressure is high. Approximately 6 months ago he changed the medication again and added a diuretic, Vitamin B-12 and Folic acid. Over time I started to experience more dizziness and fatigue and dry mouth. I had finally had enough. I stopped taking the medication, cut salt intake to less than 2000 mg per day and started walking 45 minutes daily and reduced my total intake of all foods and began to eat more fresh fruits and vegetables. I also eliminated caffeine and alcohol and began checking my blood pressure twice daily. My digital monitor consistently gives me readings of 125-130/75-80 and I feel much better. Everything I read says do not stop taking your medicine, but if the medicine is making you sicker and the doctor just seems to always want to change the medicine and conduct more tests (which never turn up anything), what should one do? It is very frustrating.

Answer: It is commendable that you have been able to control your blood pressure with a HEALTHY LIFE STYLE. Exercising regularly and losing weight by eating healthful foods can improve high blood pressure. Drugs are NOT always the "answer" for this problem. Unfortunately, many people would rather take a "magic pill" than try life style modification. You, on the other hand have taken the "road less traveled" and have clearly been successful. Congratulations! - JRS



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