Blood pressure when in AFib.

[Tobw]

What with an unrelated health matter that could have a serious outcome going on at the moment which has sent me into full blown hypochondriac mode, it's no surprise really that my AFib has started playing up a lot more with a new symptom (dizziness - which may be down to the doubling of my daily dose of Doxazosin, along with me now taking my Bisoprolol all in one go as opposed to splitting it between morning and night) as well. At the moment I'm getting episodes every two to three days (currently in one that has lasted twenty four hours plus) and my mood wasn't helped by a blood pressure reading (when I was in sinus mode) at a cardiology appointment which read read 197/88.

Although the cariologist didn't seem bothered with it, it really freaked me out and, being truthful, it was the main reason why I arranged to be taken into A and E when I went into fibrillation late on Saturday night. I also went to A and E yesterday when this episode started and was also getting pain in my left shoulder.

Between the two visits, I have had all sorts of tests done and the outcome was that the hospital staff felt they could send me home both times. This happened despite me still being in AFib (yesterday the consultant said my heart rate was low enough for me to be discharged - it varied between 60/110 bpm for the three hours or so I was hooked up to the machine, I'd say with the average value being in the 80/85 bpm range).

Anyway, to finally get to my question, I've had my blood pressure taken nine times in hospital since that high reading last week and I've been in AFib each time. Four of these readings were on my first visit to A and E and I know at least three of them, while not being as high as the original one, were high with the final one being "reduced" from the others. However, yesterday, the first three readings I had were all definitely in the low blood pressure category with the next one being 120/80 as it turned out. Then, when I had a final reading just before leaving it showed 185/145, but the nurse immediately said she'd take another one because we had been talking when the reading was being taken and I had my legs crossed, which she said would also increase the reading, - the next result a few seconds later read 137/85!

Now, I've read that measuring blood pressure when someone is in AFib can be difficult and also that some readings by electric measuring devices can be unreliable. So, how reliable are those nine results I've had? Given that all of the results were high in my first visit and low to middling in my second, it seems to me that I should trust them because it's not as if they were fluctuating wildly between high and low - is it that the difficulty comes with getting a reading and that once you have one, it can be relied upon? Also, I'm taking it as read that the equipment used by the NHS is completely reliable and that the doubts about electric monitors I mentioned earlier relate to some of the ones you can buy in your pharmacy.

Thanks for sticking with this if you've reached this far!

[rosyG]

I have found that my BP is always very high when in AF- particularly at the start of an episode. An Arrhythmia nurse said there is a strong link between BP and AF and organised a 24 hour BP test for me ( From Brompton hospital)-

I think you might need to have such a test to see what your BP usually is, but if you are wondering if your readings were accurate, I'd say it was likely they were if you were in AF at the time.

If you find your BP is high generally, it would help your AF to lower it and you can do a lot through exercise and diet- fresh fruit and vegetables, low salt etc

Sorry to hear you are having health problems.

best wishes

[Tobw in reply to rosyG]

Thinking about it, those high readings om my first visit were all taken within two/three hjours of my going into AFib, whereas with the second lot, I woke up at 1 am in AFib, went back to sleep and it was about 7 am when I rang for an ambulance, so the high readings were all taken some time into Fibrillation before the lower ones were.

[BobD Volunteer]

The machines are generally unreliable for people in AF so advised to use old fashioned method manually. Sorry about the other health issues. I know about those. Had prostate cancer three years ago. if not one thing then another eh, but we carry on regardless!

Try not to worry about the results of the BP testing. If the hospital and doctors aren't worried why should you be?

Bob

[dedeottie in reply to BobD]

My blood pressure is always low when in A.F. I have stopped taking it when I'm having an episode as it sends me into panic mode and isn't really an accurate picture of what is happening. Sorry to hear you are having a bad time at the moment and hope this.vs look up a bit for you.x

[Tobw in reply to BobD]

Thank you both for your replies. Bob, it's the prostate as well with me - I think I mentioned to you that I'd had two "slightly raised" PSA results back in April when I was peeing a lot of blood. The urologist said I should have another PSA in three months and it might be that I'll need a biopsy - everything apart from the PSA has been fine so far and I've not had any obvious prostate type symptoms in the last four months, so I'm hoping that's a good sign.

I don't tend to get too down about my AFib as a rule, but I've suffered with "white coat syndrome" all my life and, although I know you are right, the fact that I live by myself doesn't help when it comes to constantly mulling health matters over - I read that bit yesterday about an EP saying that A Fib reflected your general health and thought "Amen to that"!

Rosy, I had the riot act read to me by the cardiologist about my weight last week (I belong very much in the overweight camp of AFib sufferers rather than the endurance athlete one). Although I've been told by people in the medical profession that much bigger people than me have had ablations, he said to me that he couldn't recommend me for one (he didn't think I needed one at this stage mind) because my size meant that there would be a risk involved if something went wrong.

Having been given my weight (18 stone 5) and that blood pressure reading, I'd already decided to go on diet anyway and one of the good things to Come out of yesterday's hospital visit was that I have lost twelve pounds since then by concentrating on a fruit and veg based diet - although I walk the dog for more than an hour every day, I need to do more on the exercise side (the fact I'm in AFib so much lately doesn't help there mind), but I was very encouraged by that start.

[rosyG in reply to Tobw]

wel done- if you lose weight your BP will fall accordingly!

[jeanjeannie50]

It could be your anxiety that is taking your blood pressure up so high. The slightest bit of stress I have and mine shoots up. Also blood pressure is never consistent as it's up and down all the time, depending what you are doing and of course how stressed you are. Like Bob says I wouldn't worry about it if the hospital weren't concerned.

I would talk to your doctor about feeling dizzy as this could well be caused by your medication.

[Tobw in reply to jeanjeannie50]

I took your advice and went to see my GP this morning. He said that he thought the dizziness was more likely to be down to the upping of my Doxazosin dose rather than a change in the nature of my AFib and, the more I think about it, the more I think he's right. I've just looked at the "Common side effects" part of the leaflet in my box of tablets and there up near the top was postural hypotension and vertigo (which I've also been experiencing today) - tachycardia was also there and, while I'm not saying it's causing my current AFib (this episode is now an hour short of the longest one I've experienced), perhaps the additional Doxazosin is making it harder for my heart to get back into sinus rhythm?

There could well be a link with those blood pressure readings as well because the earlier high ones were taken when I was only on 4mg of Doxazosin rather than the 8 mg I'm on now whereas all of the recent ones have been taken on the increased dose.

As for blood pressure machines, the doctor said there was a capacity for not all readings to be reliable, but he thought it was reasonable to think that, as my readings were consistently high in my first hospital visit and consistently low/middling in my second there was enough evidence to believe that they gave a true reflection of where my blood pressure was at the time of examination - even if the precise figures given may not be reliable.

Finally, he took my blood pressure using the old fashioned method and it was 134/76 - I'd have appreciated it more if that result had come when I was in sinus mode, but it was still reassuring to be told it wasn't sky high like I half suspected it to be.

[jeanjeannie50 in reply to Tobw]

Good to hear that your BP is normal now. Did your GP reduce your dose of Doxazosin and how are you feeling today?

[Tobw in reply to jeanjeannie50]

No, he said to stick on the increased dose for now, but we'll revisit it in a week or two to see how things are going.

I went back into sinus rhythm yesterday evening after 40 hours in AFib (my previous longest episode had been 37 hours), but I was still getting that unsteadiness and dizziness afterwards and, although not as bad, it's around this morning as well. Therefore, I think it's safe to say it was the medication rather than the AFib that was the main cause of the symptoms - with the indications being that my blood pressure is more under control after the increase in Doxazosin dosage, I suppose I have to hope that my body will gradually cope with the new symptoms I have.

[SRMGrandma Volunteer]

I'm curious as to what your BP is on a normal day to day basis. Have you had hypertension for a long time and not know it, and now that you have AF it is the first time that it has been frequently measured? Longstanding high blood pressure is a known cause of AF. Doctors often brush off legit concerns unfortunately. You are your own best advocate, so if you feel there is cause for concern do get a second opinion. You've got some dangerously high readings there and it definitely warrants further investigation. Good luck and be well!

[Tobw in reply to SRMGrandma]

YesSRM, I've been on tablets for blood pressure for getting on for twenty years and it's been a question of upping the dosage until the doctors aren't left with a great deal of room to manouevre now - I'd guess hypertension is probably the reason why I've got afib. That said, my blood pressure readings are usually nowhere near that figure I had last week.

[souljacs4]

I have white coat syndrome to. My GP knows about this and as I have a BP monitor at home he suggested I take my BP over a month at different times of the day and and not when I am in AF after the month I took my monitor in to him so that he could check it against the one he uses at the surgery which he did and they both had the same readings when he worked out the average of the readings I had taken at home my blood pressure was pretty good.

[Tobw in reply to souljacs4]

I bought a monitor and found it counter productive because, stupidly I suppose, I tended to fix a time to do it and it all ended up almost as bad as having my blood pressure measured at the doctors - it was almost as if I was putting a white coat on! I also found it hard to get to work reliably despite the make of monitor being recommended to me as very good.

That said, I think I will ask if I can do something similar if I have another reading as high as the one at my cardiology appointment.

[Froggy]

Hiya - please insist that whoever measures your BP uses a pump up type (sphygmomanometer) and not an electronic one when in AF.

I have had 2 procedures cancelled at the last minute because of BP readings of around 220/110 - false readings, I have to say. the pressure, anxiety and fear I felt were totally unnecessary and needs to be addressed. I was even given Valium to 'calm me down'!

I then found that whichever electrical monitor is used, a chemist, GP's, hospital etc, does not record true readings when in AF. Whatever I read was spot on. After this and when in AF, I insisted on a pump one. Some nurses / doctors didn't believe me and thought that my request was to do with anxiety - I wasn't anxious.

Pump BP machines used in AF are the best tools for lowering BP and reducing stress - better than yoga in fact

Hope that help

[Tobw]

I must say it was very reassuring to get a pretty good blood pressure measurement from a reading done with a "traditional" monitor today.

[Loo53]

I have no blood pressure problems at any stage. Nothing else wrong with me except AF and an adverse BMI which as soon as I've gathered speed I will be addressing.

[AnticoagulateNow]

The only way to take blood pressure while in AF is the good old fashioned manual method with a cuff and stethoscope. The use of anything electronic is entirely unreliable... even if it actually displays a reading.

[Marion62 in reply to AnticoagulateNow]

I am in permanent AF - I was just wondering if I should be asking the GPs at my surgery to always take my BP manually. My BP normally is OK.

On two occasions in the last 5 months when I was feeling dizzy and lightheaded two different GPs took it electronically and said it was OK.

Thanks

Marion

[AnticoagulateNow in reply to Marion62]

I think that's a bit naughty of them Marion, they really should know better. Taken 'manually', the doctor or nurse can 'make allowances' for the irregular beat but the electronic machine simply can't do that and will return a spurious reading.