Low BP in patients with AF may be harmful

I am not sure I should read these studies since many leave only questions. But for what it is worth, it seems AF and BP are not what doctors generally believe. Below is one statement in the study. Of course more study is required for any treatment to be changed.

" We thought this might hold true for patients with AF, because they are different from the general population and from hypertensive patients. We thought it might have clinical implications because most of the medications used for rate control and rhythm control also lower BP. By giving more and more medications, are we helping the patient or are we actually harming the patient?”

The summary of the study is on this site.

healio.com/cardiology/vascu...

15 Replies

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  • Before my successful ablation, I found that my worst AF days I had very low BP and I learned to keep fluid intake up to make sure I did not get dehydrated which can lower BP, so this does not surprise me.

  • My BP always goes up when I have an attack of PAF , but I have noticed on here that some say there's will go down. I'm wondering why there's this difference?

  • My BP only ever got lower than 110/60 when I was pregnant and I have to say, that ain't gonna happen again any time soon! Interesting though - shows they're still feeling their way with this.

  • My state of health has only once bothered my husband so much that he rang for an ambulance. I'd woken with a racing heart - which was quite an unusual thing then - at about 5 am and by 8 am I thought it would be a good idea to take atenolol as usual. Not long afterwards I had become deathly pale and my husband was unable to find any hint of a pulse. I didn't feel right at all.

    Three first responders appeared in minutes, took my blood pressure which was I know not where but right down and did an ECG. They were followed by an ambulance and paramedics. The ECG taken has been invaluable. I was whisked away, 23 miles down the motorway. I was in normal sinus rhythm when we arrived. There was no escape, however. After a while my blood pressure had come up to 105/50 and they thought they might send me home. However they rang my GP and discovered I usually had higher blood pressure, so they kept me in for observation. I had a chest X ray. and a doctor told me some nasty truths which including something about blood pooling. They eventually let me go at about 7 in the evening, which was good because it was an opportunity to have something to eat. There had been nothing all day, although I did get a drink of water and a cup of tea.

    This horrid event was the start of my AF journey, although I had had a fast heart, briefly, on many occasions over the previous years. It was horrendously inconvenient (it was the day of a family funeral and I had been doing both hosting and catering for the bunfight and everyone else in the extended family had to discover a large number of last minute jobs that I had not done) but it taught me a number of lessons. One is the wisdom of asking for a copy of any ECG and another is to have a bag of Things To Take To Hospital, which should include some money, a pair of shoes, clothes to come home in and so on. Also something to look decent in when in hospital. I had been half dressed when struck down. Also not to leave so much to the last minute when guests are expected. I took my health for granted at that time.

  • I am totally fed up with blood pressure readings Whenever I go anywhere near a doctor or hospital my bp is high yet I know that it is actually low normally. I keep a daily record to show them. Yesterday it was 104/62 at 7pm. This was very similar to the final reading taken at hospital post ablation.

    Both my sons have low bp too. The youngest one was told, by a GP, that men who are 6'5" have to learn to stand up slowly to prevent frequent keeling over, to which he was prone.

  • I have often wondered why they didn't reduce the blood pressure tabs that I was on when they gave me large doses of AF medication, I thought maybe it was more ideal to have lower b/pressure than normal.

  • Its becos each patient reacts differently. My blood pressure needs quite a bit of medication to knock it down low, which means i can take higher doses of the meds, for better or worse. I have always been warned by the medics that the meds could knock the BP down, particularly in the case of Verapimil and Diltiazem, they have been very careful.

  • I know this is a bete noir of mine but are we (and doctors) actually a little too precious about Blood Pressure. (discuss) . When I was a kid they used to judge it as 100+your age over 90 as being normal. Now anything over 135/80 is considered too high. I know that my body strives to run at around 145/85 -90 and all the drugs do seems to be to drive it down for a month or two till it decides it doesn't like that and reverts to "normal." . I know I felt better without the drugs (amlodopine and losartan) but my dear GP (bless her) worries about me and keeps trying to bring it down. I'm currently running out on the last hormone implant (known to raise BP) which I had in August but it will be about three months before it is cleared from my system so it will be interesting to see if my BP sudden;t drops again. Always provided that my PSA stays 0 and I don't have to start again. So many things affect us all and I'm not on any heart medication remember- apart form our old mate warfarin.

    Bob

  • A subject close to my heart, in more ways than one. I have suffered from hypotension all my life which has caused syncope at worst and made it difficult to stand up or climb stairs at the best of times. My BP very rarely went above 100/60 so when diagnosed with AF and prescribed Biso I was very concerned, however, my GP said it also tends to stabilize BP and that is exactly what it helped to do, except when in AF when it just went so low it was dangerous - below 65/35 was the lowest recorded in the cardiac unit, at night the alarms kept going off and staff rushed to wake me to see if I was still conscious.

    So.... I haven't read the report yet but going to but what I was told was that your kidneys and liver functions need a pressure of 90/60 to work, below that there is cause from concern. I don't think there is cause for concern unless your BP drops and stays below this level for an extended period of time. Sure meds will affect it and there will be fluctuations but sustained low BP is very debilitating and dangerous.

    If my BP goes over 105/70 I feel great, but that is an unusual phenomena. Interestingly my daughter in law also suffers for hypotension so we commiserate! This is the first time I have ever heard of doctors taking this seriously as my previous GP when I went for advice just said to me 'aren't you the lucky one?' No!

  • My bp is sometimes low when I have an AF attack, I take losarten and bisoprolol, so it's being kept artificially low, at about 140/80ish, most of the time, but it gets higher and lower! So who knows? Seems totally random to me

  • I think Bob is right in wondering if we are a bit precious about blood pressure. I have had high BP since my young and fit days and it has been monitored for many years and treated with the usual Amlodipine/Lisiniprol drugs. Despite this, I was always fit and full of 'get on with it' energy. Since AF came along with the introduction of Bisoprolol, etc. my mojo has virtually disappeared along with most physical energy. My GP (bless him - he always has time for me) has differing ideas on BP than my Cardio, who seems to want to keep the BP low and pulse rate even slower. My GP is reducing the Bisop and I am now down to 7.5mg a week. I do feel better and the fact that my BP is around 142/65 seems to suit me.

    We are in the hands of our medical carers - but it is good to listen to ourselves too and provide feedback and hopefully help them to get on top of an obviously open ended condition.

  • I've just spent a week in hospital watching them doing obs every couple of hours or so. My BP was all over the place, varying between 88 and 140. At a BP of 103 or below I feel as if I'm about to pass out. On a couple of occasions I 've been given Bisoprolol on top of my Diltiazem, which I've subsequently discovered is dangerous, and I was on the verge of passing out when I was discharged.

  • I have been told that some blood pressure cuffs do not read correctly when a person is in AF. Has anyone heard this?

  • Many of the home cuffs are unable to get a reading when you are in AF. A person using a stethoscope and traditional blood pressure cuff can still measure it, and the cuffs in hospitals can too.

  • This is fascinating as one of the biggest causes for AF in the first place is longstanding history of hypertension. That pressure in the vessels, especially the pulmonary veins causes changes that beget AF. From the time I first learned to take a blood pressure, back in 1970, the gold standard for BP was always 120/80. They didn't prescribe meds until the systolic (top number) reached 140. Now they realize that is too high and all attempts are made to keep the systolic at 135 or lower. As we age, and with certain cardiac abnormalities the pulse pressure (number you get when you subtract the diastolic from the systolic) lets larger and that is called a widening pulse pressure which generally means poor elasticity of the vessels. Pulse pressure at 120/80 would equal 40. Today my BP is 130/70 so that pulse pressure of 60 is not ideal. My wildly fluctuating blood pressure has always been the bane of my existence.

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