High Blood Pressure despite drugs and risk of relapse back to persistent AF

[Turquoise19]

Hi all, would appreciate some shared experiences. My MRI suggests high BP as a main precursor to my AF, quickly got persistent but luckily well treated so far, since my ablation in July.

But ironically since starting to get fitter again and getting my weight in check, my BP has been going up again, averaging 15/60 over 110, then coming down a bit on sitting still to 140/95 to 100, after 4 goes.

GP not especially taking me seriously, when comes down a bit, but it was so much better than this, often a bit below 120/80, till a couple of months ago, when I started exercising again.

Am now taking 10mg Ramipril and 5mg Amlodipine, replacing Indapemide that really helped when I'd been in ongoing AF, and heart EF pump function was reduced.

Very interested to hear your experiences. Thx a lot

[Sharc]

I feel your pain. I think my AF is BP related as well. I had a hard time getting my hypertension under control. At one time it was 216/110. My GP even put me in hospital for almost a week to bring it down as it was being so stubborn. She was worried I would have a stroke. I am on 8mg perindopril and 5-10mg amlodipine at the moment. My BP was consistently under 120/80 for quite awhile with this combo which was great considering that at one time I was on four different meds. Unfortunately I am having spikes in my pressure again . My amlodipine dose is dependant on my pressure reading. When high I take up to 10mg. However now it is starting to get to a point that even 10mg is no longer working. I am not sure where it will go from here but it is depressing when it seemed like it was finally under control for almost a year and now here I go again. I am sorry that I can't offer you any wisdom but I wanted to let you know I certainly understand how you feel and that you are not alone . I hope you are able to get yours under control. Hang in there and take good care!

[Turquoise19 in reply to Sharc]

Thx very much Sharc, yes I am on similar meds. Just started Amlodipine 5mg, waiting for it to make a difference. Been on Ramipril for over a year, which I think is the same group as yours

Any ideas what triggers yours or what if anything in the heart, as from my MRI they don't report blocked arteries!

[Sharc in reply to Turquoise19]

I'm not sure if you are referring to my Afib triggers or high BP triggers. I do think the high BP triggered my Afib in the first place. Since my BP has been controlled I have had no episodes of Afib..though that could be a coincidence. I'm not sure about the BP though. I do have an adrenal tumour which can be the cause of high BP. They have been testing me and so far the tumour has not been secreting any hormones. That doesn't mean it doesn't, it only means they haven't caught it. I also need to lose about 30lbs which of course can also contribute to high BP, though I have weighed more in the past with no problems. It really is a toss up. It could be none of those things or all of those things. It does get depressing but I'm not about to give up yet. Ramipril is in the same group as perindopril. I have been on perindopril for quite some time, amlodipine was added about a year ago. Do pay attention to any leg swelling as that can be a side effect of amlodipine. I haven't had an MRI of my heart but have had two echocardiograms which showed everything normal including my EF

[cuore in reply to Sharc]

Perindopril is an is a long-acting ACE inhibitor and Amlodipine belongs to a class of drugs known as calcium channel blockers. You might want to read up on ARBs (angiotensin receptor blockers)

I had read that ARBs worked well for both hypertension and AF but I can't find the site to post it. Obviously, I am not medically trained so you might want to pass it by your GP. It seems you have a great GP, and by no means do I want to interfere.

I take 5 mg amlodipine and 20mg Olmesartan.

[Turquoise19 in reply to cuore]

Thx very much Cuore, yes I had wondered about the difference between ACE inhibitors and ARBs in what they do. Know about the Amlodipine is a calcium channel blocker. And if the long acting one you mention may work better for me.

My GP is ok, in that he agreed to change from the Indapamide for me, as made sense I nolonger need that, as nolonger in persistent AF and my EF pump function is working ok again now. This did bring my BP down well though at the time.

Do feel I have to do all my own research tho, as they admit themselves they are just generalists, will have to wait till my next cardio review with my EP I guess.

So really appreciate being able to hear your experiences and others in here

Thx v much for suggesting that.

[cuore in reply to Turquoise19]

One EP told me he was not an expert on blood pressure drugs when I asked what blood pressure drug would be compatible and best with Propafenone. He said I should consult a specialist/expert. The other EP required a list of previous blood pressure medications that had the least side effects and worked the best for me. So, he just prescribed something already tried and which had not worked. He really wasn't interested in the blood pressure field. Good luck that your EP review goes better about blood pressure. I do hope you post an update because I would be interested to know. I definitely agree that you have to do your own research.

[Turquoise19 in reply to cuore]

Thx v much, yes will post again when a bit more in the know. So good to have this discussion forum here. 🌞

[sleeksheep in reply to Turquoise19]

I had wondered about the difference between ACE inhibitors and ARBs in what they do.

This is only particular to my family history with my mother and grandmother having died of lung cancer . ACE inhibitors are associated with a higher incidence of lung cancer compared to ARB's.

bmj.com/content/363/bmj.k4209

My Dr. switched me from Perindopril to Telmisarton and my blood pressure has been lower ever since (117/73 ) and I lost weight very quickly so I can only assume that the ACE inhibitors where reducing my metabolic rate quite drastically.

I was on three monthly blood tests to make sure kidney function was not impaired after the change of drugs.

On a side note my chemist changed me from Telmisarton to Mizart ( both are Teltarton ) and I felt very nauseous and didnt sleep well and after a week I realized it must have been a change of drugs and that was the only one. Switched back to Telmisarton and made a note on the scripts no substitute , alls good now.

[Turquoise19 in reply to sleeksheep]

Wow that's a good result. Do u mind if I ask you what yr AF history is ? What most likely triggered it, if persistent etc. I will look up Telmisarton, never heard of it.

Thx v much

[sleeksheep in reply to Turquoise19]

Had AF since 2009 - what most likely triggered it ? Good question , probably overexertion , life time of pushing too hard when tired . When not cardioverted I am in persistent afib but had 4.5 years in sinus rhythm untill last December. My guess is a little bit too much Christmas cheer brought the latest bit on.

As for Telmisarton - its an ARB - all ARB drugs have "art" in the name same as all ACE inhibitors have "pril "in their name.

I would have said at one time all ARB formulations work the same but my experience is contrary to this , so maybe even trying a different manufacturers formulation is worth a try just to see if the results are identical.

[Turquoise19 in reply to sleeksheep]

Thx for that. We are all so different.

I would just like my BP to be better managed . So maybe gives me a better chance of not getting the AF back any time soon after my successful ablation.

My elderly mother is just on Amlodipine, with dementia and so many other health complications yet her BP is consistently better than mine !

[Sharc in reply to cuore]

Thanks cuore, I appreciate your input. I will certainly spend some time reading about ARBs. I've been lucky with my GP for sure but unfortunately she will be retiring this year. Not sure what I will do then. It's hard to start over with someone new and that is if I can even find one in my town where we currently have a doctor shortage.

[Desanthony]

Are you on a cardio rehab course to get you back to fitness? I haven't had an ablation yet waiting for one and should have on around March time. Will have my 3rd cardioversion next Tuesday. Was recommended to go on Cardio rehab course by a friend who had done it. No Doc mentioned it but when I went to the Doc and said about it he referred me. When I moved house I found info from the internet and think it came off the British Heart Foundation website. The exercises start out slow and you may feel a little silly if you are normally fit and active but you do learn a lot. Usually you have a physio and a specialist heart nurse at the lessons and they check your BP and HR all the way through the class. I think I ended up doing nearly 18 months with them working back into the gym and now I go regularly even when in AF and regulate myself with what I have learned from the course.

[Turquoise19 in reply to Desanthony]

That's interesting, no I haven't heard about that. Had been wondering about the fitness stress test.

Will look up cardio fitness rehab. Are they hospital based ?

[Desanthony in reply to Turquoise19]

At my first address they were based at the local leisure centre at my second address I first went for a test at the physiotherapy department at the local hospital and from then on at the leisure centre where they hired a room for the first lot of classes and then we went on to the gym with other fitness instructors.