A Fibb and Hypertension

[RajaRua]

I have had A Fibb on and off for 4 yrs but this year had 6 episodes lasting up to 36hrs between April and the end of Sept. Got to see an EP and he put me on Flecinide 100mgs twice a day. I had been on Bisoprolol 5mgs a day to help with both A Fibb and High B/P. I found Bisprolol had a terrible effect on me over the year I was on it. Depression, exaustion, an irritating cough, weight gain. So I was taken off that. My B/P is now up at times according to 24hr monitor and I was put on Ramipril 2.5mgs last week which I had to stop as I was soooo dizzy I thought I would collapse. My feeling is that these Angio tensins or ACE inhibitors which actually suppress your adrenals don't suit me but my EP says these are the best ones to take when you have A Fibb. Is there anyone out there who is taking a differant kind of Anti hypertensive? like a calcium blocker or a diuretic or a vaso dilator?? and does anyone know why the adrenal suppressors are supposed to be best? I need to understand this and can't get an explanation. My doctor behaved like I shouldn't even ask the question. I was a nurse in the past so I have some knowledge and I guess that's why I want to fully understand how medication works. I am very aware also that my Adrenals are not the strongest as I have episodes of ME type symptoms in the past and have also been diagnosed with Fibromylagia in the past with all that entails...joint pain tiredness and headaches. I'd be grateful for any help anyone can give me. Thank you.

[SRMGrandma Volunteer]

Hi Billandben. That's a good question! I too have A Fib and hypertension and I've been on ACE inhibitors in the past. Actually those were the first drugs I was on decades ago when I first had hypertension. Other than the cough, most people feel fabulous on Ace inhibitors so that's too bad they aren't working for you. If your doc is willing to work with you, a lot of the side effects of those type of drugs can be titrated out. In other words, if you go off of it and take something else for a few weeks, and then slowly build up to your target dose you'll find the cough is gone. That approach worked for me and I was able to take them for years until my BP just was getting high again.

I totally understand that as a retired nurse you need to understand how all of this is working, and shame on your doc for acting as though you shouldn't ask. Your physician is right though, that ACE inhibitors and ARB class drugs are a good choice because of their mechanism of action which in part is, reduction in atrial stretch.

— Atrial stretch, due to increased left atrial (LA) pressure, is associated with changes in the refractory period ( recovery between heartbeats) and electrical conduction properties of atrial heart muscle. These abnormalities can be potential triggers for the initiation and perpetuation of AF. The hemodynamic effects of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) result in improved ventricular function and also reductions in LA pressure and wall stress that can damage the heart wall.

Having fibromyalgia on top of it all must be difficult and it can muddy the waters when it comes to determining which symptoms you have are from a medication vs. disease process.

I hope you can get it all figured out soon. Be well.

[RajaRua in reply to SRMGrandma]

Hello Grandma! Thank you so much for your reply. It means a lot to me. I went to my GP today and she has agreed to let me start on a half of 1.25mgs which I'll begin tomorrow. Just a wee question I forgot to ask her. Would it be dangerous to go on any other type of anti-hypertensive drug? She also said that Ramopril is usually well tolerated but we are all differant. It may not be for me but I'll give it try. She was talking about taking blood test after 2 weeks as Ramopril can cause kidney damage! I'm usually more into alternative medicine. Herbal and Homeopathic remedies, massage Yoga and meditiation. It truely is hard for me to be talking medication. I stopped being a nurse as I couldn't bear pushing medicine on people. I know they keep people alive and relatively healthy but the side-effects can be worse than the disease sometimes!

Just heard that Nelson Mandela has died!! May he rest in Peace the dear man gave so much in his life.

Thanks grandma and Blessings

Biddy

[SRMGrandma Volunteer]

Hi Biddy,

I'm glad you are having conversations with your GP about the best BP meds for you. Ramopril can also prevent kidney damage in people with long standing hypertension. I know it is scary to be on medications and I love that you love the homeopathic remedies and holistic therapies too. They are amazing helpful as an adjunct to the meds that we must take. I know that when I explain to my patients that many of the medications that we prescribe are plant based too, it makes it easier to swallow, so to speak! Everyone does react differently to medications and reading possible side effects can be scary and yes, sometimes the side effects can be worse than the disease. That's why we all have to have good conversations with our health care providers to find the best

combinations for us.

As for your question of whether or not it is dangerous to go on another type of drug, there are many categories of drugs that may work for your hypertension. Many on this forum are on beta blockers for rate control too. The high blood pressure is what is really dangerous so we have to just bite the bullet and take the drugs.

Keep us posted on how you are doing on the lower dose. Blessings to you too.