Beta blockers...low pulse but high blood pressure

Before my first and only episode (so far) off flutter, my blood pressure was typically 128 over 78 with a pulse of 72.... No health problems at all... Now I am here with these motoprolol and I am taking 25 mg twice a day as the 50s made me a walking zombie... My blood pressure is now 145/75 with a pulse of 57.

The metoprolol has a big effect on me as it stopped my heart for 5 seconds (times 5) when administered with Cardizem

I reckon the heart is beating so slowly that it has to thump harder ...hence the high 145 systolic...

I am thinking that I should scrap even the 25mg beta blocker at this stage....There is no sign of the flutter returning and I even feel chirpy until 8pm when I fight to stay awake......

Thoughts ?

Is 57 that low? Mine is typically 52, and runs 47 at night. I am on BB (bisoprolol) for my BP. Which was hugh and likely contributed to my Afib. I have had one episode, in late November 2018.



Edited 1 time(s). Last edit at 05/03/2019 01:27PM by katesshadow.

Beta blockers lower BP, so it's unlikely that the metoprolol is at fault, but who knows. Maybe you have a paradoxical reaction to it. The pauses you experienced were probably due to the diltiazem, not the metoprolol.

There's really no benefit to taking metoprolol if you're not actually in afib or flutter. Just carry it with you and take it if/when you go into that rhythm again. Beta blockers make me feel like a zombie too, so that's what I would do.

Quote
katesshadow
Is 57 that low? Mine is typically 52, and runs 47 at night. I am on BB (bisoprolol) for my BP. Which was hugh and likely contributed to my Afib. I have had one episode, in late November 2018.

Everyone had different circumstances Kate so you may be ok on 52.... They say that Marathon runners etc have a pulse of 40 !

What worried me is that
A: I have been around 72 pulse for many years (every hypochondriac has their own blood pressure meter; and I have two !)...

and B: When my heart stopped for seconds in the hospital...the rate was dipping under 50 (I was watching it), which is not normal for ME but may be fine for you...

I get conflicting info online and some say B blockers reduce rate and pressure, and some say the reduction in rate causes the heart to beat stronger which forces up the the systolic pressure... I am still reading a lot to try and figure it out.... I have just mowed the lawn and I am now at 140/80 with pulse of 62 which is ok as I had my 25mg metoprolol 6 hours ago...... I am going to miss the 25mg tonight and see what happens on the machine in the morning...(If I get that far...eeeek !)..In any case I will keep taking the morning 25mg for a week and take regular readings twice a day.....

Quote
Carey
Beta blockers lower BP, so it's unlikely that the metoprolol is at fault, but who knows. Maybe you have a paradoxical reaction to it. The pauses you experienced were probably due to the diltiazem, not the metoprolol.

There's really no benefit to taking metoprolol if you're not actually in afib or flutter. Just carry it with you and take it if/when you go into that rhythm again. Beta blockers make me feel like a zombie too, so that's what I would do.

Sounds like a plan...as I just replied to Kate, I am going to cut the evening 25mg out; keep the morning 25mg for a week, and measure my pulse and Bp twice a day on my machine..... Just now I'm running at 140/80 with pulse of 62 after mowing my lawn with the tractor.... and I am happy with that for a starting point, and hopefully in 2 weeks after I have been off the blockers for a week, I hope to be back to my usual 128/76 and pulse 70 ..

I have had a lingering neck/headache for almost 3 weeks since I started eliquis and the B Blockers, but I dont know if its one of them, or the dratted steel bed in the hospital.... lol

Allserene

When I got my first episodes of AF, my doctor put me on a beta blocker, I felt terrible, no energy. Then when I got an episode of AF and going back in NSR my heart rate dropped to a flat line for a few seconds, it was caught in my doctors office. My EP had me immediately admitted to the hospital for a pacemaker. I was in my EPs office one time and happened to read my chart and he had noted that the beta blocker probably caused my 1st. degree heart block.

I don't understand why you have to take Eliquis plus the beta blocker after one episode of Atrial flutter, I would see a EP instead of a regular MD. You could keep the beta blocker on hand if you ever go into flutter again. I find that doctors prescribe too many meds that really aren't needed.

Liz

Quote
Elizabeth
Allserene

When I got my first episodes of AF, my doctor put me on a beta blocker, I felt terrible, no energy. Then when I got an episode of AF and going back in NSR my heart rate dropped to a flat line for a few seconds, it was caught in my doctors office. My EP had me immediately admitted to the hospital for a pacemaker. I was in my EPs office one time and happened to read my chart and he had noted that the beta blocker probably caused my 1st. degree heart block.

I don't understand why you have to take Eliquis plus the beta blocker after one episode of Atrial flutter, I would see a EP instead of a regular MD. You could keep the beta blocker on hand if you ever go into flutter again. I find that doctors prescribe too many meds that really aren't needed.

Liz

Exactly my conclusion Liz.... I am easing myself off Metopropol (now 25mg with breakfast only)....and I should be free of it in a week... Then Eliquis is next by mid month...They stick you on this stuff, but then you google 'stopping it' and there are massive warnings saying you will die if you stop it, and dont do it without careful medical supervision. They dont tell you that when they start you on it..... Its like a job in Saudi Arabia....they dont tell you that you need an EXIT VISA and only your boss can give you one......



Edited 1 time(s). Last edit at 05/04/2019 09:05AM by allserene.

Further report: It didnt work.... I was only on 25 my twice a day and eased myself off over 3 days..Felt good. Hooray. THEN:

Yesterday 2pm first day of zero Metorprolol. First a systolic pressure of 170...then 1 hour later...Bag of ferrets mating in my chest..yes the FLUTTER was back !..
Fired up the pressure arm cuff and yes 150 pulse... DRAT !

Took a 50mg at 2pm then a 25 at 7pm... Went to bed fluttering 10pm
Woke up 1am all quiet and feeling great. Didnt need to machine to know I had converted...
Took another 25mg (it had been 6 hours) ...

Up this morning and took another 50mg (to make sure)....

MY Conclusion is that coming off Metoprolol ... CAN cause a 170 systolic pressure quickly followed by a 150 beats flutter

Quote
allserene

Is 57 that low? Mine is typically 52, and runs 47 at night. I am on BB (bisoprolol) for my BP. Which was hugh and likely contributed to my Afib. I have had one episode, in late November 2018.

Everyone had different circumstances Kate so you may be ok on 52.... They say that Marathon runners etc have a pulse of 40 !

What worried me is that
A: I have been around 72 pulse for many years (every hypochondriac has their own blood pressure meter; and I have two !)...

and B: When my heart stopped for seconds in the hospital...the rate was dipping under 50 (I was watching it), which is not normal for ME but may be fine for you...

I get conflicting info online and some say B blockers reduce rate and pressure, and some say the reduction in rate causes the heart to beat stronger which forces up the the systolic pressure... I am still reading a lot to try and figure it out.... I have just mowed the lawn and I am now at 140/80 with pulse of 62 which is ok as I had my 25mg metoprolol 6 hours ago...... I am going to miss the 25mg tonight and see what happens on the machine in the morning...(If I get that far...eeeek !)..In any case I will keep taking the morning 25mg for a week and take regular readings twice a day.....

My pulse before I started the beta blockers was probably 70, so the 52 is low for me. And, when I see the 47 at night (which I don't check very often), it does make me wonder if that is too low.

I was diagnosed with Afib in November 2018. That was when I was put on the beta blocker, calcium channel blocker and Eliquis. Two of those are because of my blood pressure, which was high. I took the Eliquis for 2-3 months but when I saw an EP, he told me to only take it if I had an episode. He based that on my CHADS score.

Quote
allserene
MY Conclusion is that coming off Metoprolol ... CAN cause a 170 systolic pressure quickly followed by a 150 beats flutter

Although a spike in BP isn't surprising, you're jumping to conclusions with the flutter. It's very unlikely the metoprolol had anything to do with it. Flutter is just like afib -- it starts when it wants and usually for no particular reason. If you start concluding that whatever you were doing (and paying attention to) prior to an episode, you'll soon have a long list of random things you think are triggers.

Quote
Carey

MY Conclusion is that coming off Metoprolol ... CAN cause a 170 systolic pressure quickly followed by a 150 beats flutter

Although a spike in BP isn't surprising, you're jumping to conclusions with the flutter. It's very unlikely the metoprolol had anything to do with it. Flutter is just like afib -- it starts when it wants and usually for no particular reason. If you start concluding that whatever you were doing (and paying attention to) prior to an episode, you'll soon have a long list of random things you think are triggers.

Agreed...I do tend to log everything I was doing and probably wrongly attribute that as a cause.

Examples:

30 seconds before the flutter I drank (glugged) some really cold sports drink from the fridge and I felt it shocking my innards
1 hour before the flutter I saw 170 as the systolic on my BP machine as I came off meto.

Whether withdrawal from meto was involved in ANY way with the flutter, I have learned that even coming off 25mg twice a day (for me), would involve 2 to 4 weeks of very steady scaling down and a halt at each level...

When I get to the EP in July, I will ask him just WHY I am doing Meto ...and it will be interesting if he says its to avoid an event...

After 2 days on 50mgs I am switching back to my usual 25s tonight, although I have felt mostly fine today on the 50...except for being catatonic for an hour at lunch time after an hour pulling dandelions...

Thing is about the flutter, that it gives you a wave of fear as you see the 150 beats...as does seeing 170 on the BP meter when you try and come of meto too quickly.. It's the fear of the unknown and where you are headed...

Upside is the sheer wave of pleasure when it lifts and you see 128/84 with 58 pulse...(even though I would prefer 68 pulse which is nearer my pre-meto number)...



Edited 2 time(s). Last edit at 05/06/2019 07:10PM by allserene.