Topical items re INR, Bisoprolol and Blood pressure

Hi everyone,

My INR test date (I self test at home with my own Coaguchek XS device) was Tuesday 5 Nov. I rang the surgery but the number was engaged and I then promptly forgot all about ringing back later.

Around lunch time the senior INR Nurse at the INR Clinic at my GP’s surgery phoned me .... then I realised the error of my ways and just blurted out 2.5 at 07.50 hrs - then I got a mild rollicking and the remark .... ‘my goodness you are very stable on Warfarin’ ... which is so true (thank goodness). I’d forgotten to ring my test results through after all. OK, I got my new dose instructions, and my new test date.

She then told me I was due for my regular blood pressure test at the surgery. I duly protested and said my GP had already done this as part of my bus drivers medical for DVLA a few weeks earlier. She checked and confirmed what I’d said - then said we’ll do it anyway. Then she told me I was due for my Coaguchek device readings to be assessed relative to the Clinic’s device to ensure that all my INR readings are close to or the same as those of the clinic. No worries.

Then I took the opportunity to hit her about blood pressure medication. This follows a conversation I had on here with an AF’er a week or so ago about Bisoprolol/ BP control/HR control.

I asked her how and why Bisoprolol can be used for both HR control and BP control. I pointed out that I am now on 3 types of medication for BP control, Ramipril, Felodopine and Bisoprolol - which I was told was for HR control, which it is doing very well. How can Bisoprolol be prescribed for HR AND BP control ?

I summed up that I’ve had no review of medication now for between 9 and 12 years !

She said .... we’d better talk about it when you come in .... so I have an appointment for Wed 13 Nov. Hmmmmmmmmmmm !! Watch this space.

Just tossing this in as an interest item. If anyone wants to comment ... no problems.

John

[ILowe]

There are several interesting questions here.

You ask, " how and why Bisoprolol can be used for both HR control and BP control." Well, as you can imagine, many medicines have several effects, which means they have one or more uses. Bisoprolol is usually regarded as a rate controller, but is also used in blood pressure control. This can be a nuisance, but it can be an advantage.

A useful, accessible site I use is drugs.com and there are other good sites.

[Hidden in reply to ILowe]

Many thanks for that link. Very useful.

John

[MargaretWendy]

All very complicated. Google search might have an interesting answer to can Bisoprolol be used tHR control and BP control. My only message these days re heart problems is please go to a nutritionist and see what they can do to get your body working well naturally. I was lucky and am now drug free - but everyone has different problems with their hearts. Wendy

[Hidden in reply to MargaretWendy]

Hi Wendy,

Yep, I agree with that re Nutritionist. I follow her advice re food and diet and have done so since Sept 2011 as a result, combined with medication I have had only one AF event since April 2015 and that was sleeping on my left side in Feb 2018. This year I have had a couple of incidents of very fast HR (up to 149) which knocked me around for a few hours but didn't progress into AF. These were all food related.

All that said, no way would I go drug free. Just don't feel like playing 'Russian Roulette'.

John

[Thomas45]

How odd that they were annoyed at having to wait for your INR result. My arrhythmia nurse emails me and I normally reply within two days.

Earlier this year I had a diagnostic colonoscopy without coming off Warfarin, followed ten days later by another colonoscopy when I'd come off warfarin to remove the polyps they'd found during the earlier colonoscopy. I was told that they wouldn't do the second colonoscopy unless my INR was at 1.0 or 1.1. When I tested it on my own coaguchek meter both 3, 2, and 1 day before the procedure it was 1.3 each time.

I told them and they decided there could be something wrong with my meter so tested it on an hospital meter. The result was 1.3. They decided to go ahead with the procedure.

[Hidden in reply to Thomas45]

No not really. I am normally so on the ball, to the INR nurse it was highly unusual for her not to have had a message from me giving my INR reading and as a precaution she decided to follow up. Better safe than sorry ...... I might have forgotten totally. She wasn't to know. In any case she had other issues to discuss too. The bit about getting a rollicking was a bit in jest. I have a great relationship with my surgery and INR people.

The normal arrangement is for the INR patient to phone in their INR reading first thing - 8.30 am to 9 am, and the INR nurse phones back within 4 hours with new dosage and new test date. I'm normally around 10 weeks nowadays.