High blood pressure medication

[Kjsp]

My AF is under control at the moment as only getting an episode maybe once a month or every six weeks, which usually terminates when I take my flecainade and metoprolol as PIP. My problem now seems to be high blood pressure which I have been monitoring carefully for the last couple of weeks. I have a GP telephone follow up appointment on Monday and pretty sure will put me on BP medication. I know you can’t recommend or advise on particular tablets but I would be interested to hear what other AF sufferers take for HP as there seems so many combinations and I don’t want to upset my AF as it is quite manageable at the moment. Thank you in advance and wishing everyone a safe and merry Xmas .

[Hidden]

Hi Kjsp,Can I begin with asking if you have had an ECHO and if as a result have you received a comment on your Left Atria ( Atrium) ?

I ask this because to the best of my knowledge a prolonged period of time with undiagnosed and untreated high blood pressure can be a contributing factor to AF and if at the same time the LA is dilated can be a contributor to an AF generated stroke.

That said I have Ramipril and Felodopine specifically for high BP while I have Bisoprolol for HR control ( although I am informed that it also has properties for high BP - even though I have not seen/read of any reliable evidence of this).

With this concotion ( I am 76) my BP is 130/70 ish and my HR runs between 63 and 67 bpm.

Hope that helps.

John

[Kjsp in reply to Hidden]

Thank you JohnI had an ECHO earlier this year and an angiogram as recent as October and no issues were found. This high blood pressure with headaches and visual auras is a new symptom. I’m 58 and was reasonably fit with a resting heart rate around 48 ,when I was previously on bisoprolol my rate could drop to under 40 so hoping they might be other alternatives for me.

[Maglynne007 in reply to Hidden]

Hi, reading your reply above can I ask what is the significance a dilated left atrium I only ask as I was diagnosed with this following my one and only bout of AF at the age of 59 (which lasted 3 days) on Christmas night last year. I paid privately to see a consultant (to be honest it frightened me) which resulted in this diagnosis. My consultant advised Dr to stabilise My high BP and so after a bit of tweaking with medication I went from 4mg of perindopril to 8 mg perindopril and 10 mg lecandipine - though my BP still fluctuates now. The consultant further advised that once my BP lowered he recommended anticoagulants. I don’t like bothering my Dr (we have a 1 Dr practice) but I have reminded him twice now about this and he said leave it with me. To be honest I don’t think he wants to give them to me because I am very overweight. Whilst I haven’t had a further bout of AF I have got a very irregular heartbeat and bradycardia. I sent my GP copies of ECG taken from my Apple Watch but he sniggered at me and said everyone has them. Perhaps I’ll ask him again in the New Year. Merry Christmas

[Hidden in reply to Maglynne007]

Hi Maglynne,

I'll start answering your question with this extract from my discharge letter ( from Cardiologist to my GP at the time -Jan 2010).

"I note an echocardiogram performed in January 2010 showed a mildly dilated LV cavity with good systolic function. LA was dilated at 5.1 cms, with LA area 30,4 cm. No valvular abnormalities were seen.

I told Mr Ling that his enlarged LA would pre-dispose to him developing AF again in future, and that I felt it would be best served by staying on Warfarin long term. He was-very happy with this

decision, and told me that this was also his personal preference."

However, since those days ( nearly 11 years ago now) I have learnt that an AF sourced stroke can emanate from the LA (Left Atria) and that a good many of these types of strokes can be fatal.

When I moved to Cornwall I firstly ended up with a dinosaur of a surgery and eventually found another which was ( and still is) brilliant. No sweat. Is there any vague possibility of you finding another surgery which might be termed modern and progressive ?

Anymore questions just ask away.

John

[Maglynne007 in reply to Hidden]

Thank you so much. I don’t even think my Dr has read the report. Our surgery is merging with another larger surgery in the New Year and my GP is retiring (not sure how soon though) and was thinking of waiting till then. But reading your informative reply I think I’ll phone the surgery again this afternoon. I understand there are different anticoagulants/warfarin as I work in a hospital and our office is attached to the warfarin clinic which is always very busy. I might even contact the consultant I saw and ask if I can have a copy of the report he sent to my GP. Time to be assertive I think. Thank you.

[Hidden in reply to Maglynne007]

Hiya Maglynne,Well, it sounds as if your new surgery has a chance of moving into the 21st Century😃

Yes, there are different anticoagulants - new ones known as NOAC's (like Apixaban) and good old rat poison ( as my daughter once described it) - Warfarin.

When my AF was diagnosed these NOAC's did not exist other than in development and trial stages so there was no alternative for me but Warfarin. My new GP has tried to get me to agree to come off Warfarin and onto a NOAC but I've refused. I have no problem with Warfarin and see no reason to break with it and move onto any one of 4 or so NOAC's and probably have untold side effects.

My surgery have a great INR Clinic and they totally support me in self testing my INR at specific dates. My INR readings are around 90% constant in range. They usually fall out of range if I mess around with my greens ...... I hate greens 😮 I use a Coaguchek device which I take wherever in the world I go. I phone in my INR result leave a message with surgery reception and several hours later get a message telling me my next dose and next test date. Simples. Periodically the Clinic call me in with my device and we do a double INR test ... one finger puncture and drops of blood on the test strips on the surgery device and my device. In this way the Clinic are happy that my device is giving similar readings and is accurate. The error margin is + or - 0.1 between the two devices. Often exactly the same reading.

John

[etheral]

I have hypertension as well as afib which has been totally controlled by Tikosyn ( apparently not available in Europe ( although of you are in UK, don't know of Brexit will affect this). Some people take beta blockers regularly for hypertension such as Metoperol. If you don't get side effects, mainly lethargy this might be a consideration. I take Entresto which was originally prescribed when I was on Afib and heart failure and andcontiñued it after my afib and failure were resolved.

It seems to keep my BP which always ran slightly high under control..mostly in the 115/75 range.Diuretics such as hydroclothiazide or Lasix

are cheep and often prescribed. They have their own problems mostly having to urinate frequently and sometimes suddenly. The best course of action can only be determined by your cardiologist'.

[Cha275rL]

I have had HBP since my son was born, and I had pre eclampsia, that’s 44 years ago. I now take 50 mg atenolol and 2 mg perindopril along with a water tablet (indapamide) which seems to keep it under control, unless I have an AF attack, then it goes mad. I haven’t been given a PIP, probably because I don’t have the attacks too often ( thank God).

[DevonHubby1]

Wife was diagnosed with PAF and put on Bisoprolol. She was also sufferring from slight hypertension so cardiologist suggested she be put on blood pressure tablets. Took a while to convince GP on this but it did seem to help reduce episodes of PAF.

[Clyde12]

I am on Losartan for high blood pressure and my AFib is almost non existent these days. At a routine check up with cardiologist last year I was told that because my BP was under control that’s why my AFib wasn’t so evident. My resting heart rate does go to mid 40’s during night rising to 55 on average during day. Good luck to you.

[cuore]

You may need only a small dosage of a blood pressure pill. So, it would be worthwhile to get to know the classes of the blood pressure pills. In the past the GPs would automatically prescribe a diuretic (water pill) as a first line of treatment. For those with Af, a diuretic as a first line may not be the wisest choice because It might cause an electrolyte unbalance, and an electrolyte unbalance can cause AF. Two other choices are ACEs and ARBs. I have an article saved as a PDF as opposed to the link, but I have recopied it here:

Adv Ther (2019) 36:278–297 doi.org/10.1007/s12325-018-...

Although not a PDF this link gives a short summary of the above article.

pubmed.ncbi.nlm.nih.gov/305...

As a result, considering I have AF, I am taking a combination of Olmesartan 20mg ( an ARB) and Amlodipine 5 mg. (a calcium channel blocker) .

[Kjsp in reply to cuore]

Thanks everybody for your replies

There has been a development ! To cut a long story short after an unplanned ambulance ride to A and E this morning I have been dispatched home with Amlodipine and I await the call from my GP tomorrow

Thankyou

Stay safe and stay well

Karen x

[irene75359 in reply to Kjsp]

Are you alright, Karen?

[Kjsp in reply to irene75359]

Yes I’m ok now , or at least BP seems under control and heart behaving. Thankyou Irene