I have PAF (details in Profile) and generally have episodes every week or two. I have been just been looking at my blood pressure readings over the last 6 months and comparing to readings whilst in AF.
- Generally the BP is 100/70. Pulse is 60bpm
- When AF is evident, the BP is around 85/60. Pulse increases to 75bpm (with no ill feelings from the low BP)
I hadn't noticed this before but it seems to be the case in over 50% of the episodes. It just seems to be too much of a coincidence.
So the question is:
- Could it be the low blood pressure that initiates the AF? or
- Does the AF cause the lower blood pressure?
Cheers!
Vince
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Vince1001
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Because of the nature of AF and the constantly changing hydraulic pressure - see Dr Gupta’s video explaining how this works - hence needing to take 3 sequential readings and taking an average AND many people don’t rest before taking a reading AND it is the average BP during different times of the day/night which is important rather than a one off reading.
As is common with most people my BP is always high when checked at hospital during appointments. I commented on this during one of my first EP appointments.
Apart from mention of ‘white coat syndrome’ I was told that it was just something that they did as a routine and even the hospital BP monitors can’t be fully relied upon with AFib.
CDreamer, thank you for the info. I will be sure to watch the video. I was given the same direction as you mentioned at the hospital. Thank you for the reminder.
For the reasons as given by CDreamer . It’s what we are frequently told by medics but you should follow the advice of your cardiologist. Of course, there is no reason why you should not ask (tactfully) if they are accurate. Medical equipment is changing and improving all the time so it might also be a good idea to ask your cardiologist to recommend a suitable unit. Many detect an irregular heartbeat but that does not necessarily mean they provide accurate BP readings for folk in AF......
Yes, the Omron M6 provides the average of 3 readings but I think with only 30 seconds between each reading. I understand that for folk with AF, medics recommend taking the average of 4 readings, with a minimum of 15 minutes between each reading. Obviously this can be achieved with any BP monitor including the cheaper M3. The result is still only a guide because BP changes all the time, with or without AF.
- Could it be the low blood pressure that initiates the AF? or
- Does the AF cause the lower blood pressure?
- Both are possible.
For me it was always low BP could, but didn’t always, trigger AF but often tachycardia, into AF.
But then my BP would rarely ever be as high as 100 systolic - I was lucky if it ever got above 90 systolic and spent most of my time 75-80. Once in AF it would then go unreadable and everything went black if I as much as lifted my head from pillow.
BP is considered low once it dips below 90 systolic. You can get a reading from a BP machine if it is a brand which is Arrythmia compatible but you need to take 3 readings, having been in a resting position for at least 10 minutes, and then take the average of those readings - which may be widely variable - very low 1st reading, high next, then low. A one off reading is meaningless. I frequently had to have 24 hour BP monitors.
Reasons you can end up in AF if you do have low BP is dehydration and electrolyte imbalance which is why I was told to drink more water and consume at least 6g of salt daily, which I found quite difficult to do as I hated salty tastes.
I’ve had so many changes it’s impossible to say any one thing resolved the low BP, pacemaker, meds I take for another condition which I happened to find out were also used for low BP - but readings of 100 is not considered low, once it goes under 90 then it is of concern. When in AF it may dip upon and down but that’s to be expected. In my case I had a very low BP ALL of the time, which went unreadable in AF.
Certainly talk to your consultant, look at hydration first and then nutrition and ensure your diet has enough mineral content. We have been brainwashed into thinking salt is ‘bad’ for us and indeed too high sodium serum levels with high BP are not good, but not enough thought is given to considering if enough salt if being taken if you have consistently low BP. As long as you avoid processed foods which do contain high sodium levels, we do need to add some salt to our food. 6g is not a lot = 1 teaspoon for all food in one day. The usual recommendation is to not exceed 6g.
John I always rationalised that when I was in AF blood supply was compromised and my body tried to keep blood going to the right areas by increasing my BP (shrink the blood vessels, Boyles law etc etc ) Which is why my BP always went up in AF or for that matter any arrhythmia. Of course such reasoning is probably pointless since we are also different but for sure it will do one of three things. Up, down or nothing.
Unfortunately it is so elusive that no one has yet found it.
O2 was another consideration for me as my night time levels would dip and that certainly brought on nocturnal AF. I had a sleep test with revealed sleep apnea- now treated with CPAP which had an immediate result of no more nocturnal AF.
Yes do check out what an increase in Oxygen does for you during the night. I was conscious of oxygen deprivation often waking feeling under par and with a headache until I got some fresh air; plus in the early days AF. I had a sleep test found mild sleep apnea, no treatment provided by NHS at that level. So took Lifestyle action - Breathright nasal strip and for the last 6 months a mouth strip (for more info on the latter see James Nestor's book 'Breathe' & Patrick Mceown Oxygen advantage, both on YouTube. Big improvements.
My BP usually goes up when my afib/tachycardia starts. However each time my home monitor says different readings so my cardiologist snd GP both say take it 3 times and the average or as one said best of 3. Keep well
Hi, it’s an interesting question, but my blood pressure has always been on the high side( even on meds) and my pulse between 84-120. It was also mentioned to me that a possible cause of my AFib could have been high blood pressure. We’re all so different though aren’t we?
The glib answer to this question but one, judging by the replies in this thread with an element of truth in it is, "Pattern? The only pattern is no pattern!" I have given up taking BP readings, pulse measurements, tracking my Afib on my Omron etc. I sort of know how I feel at any moment in time, without the devices telling me one way or the other. I am hoping that the fitting of a CRT pacemaker (plus AV Node ablation) in the summer, all being well, will impose some sort of pattern . Who knows?
Since everyone responds to AF differently it could be for you. I actually have high blood pressure when in AF. But that is the way my body responds to AF. If you have concerns of the effects the low blood pressure is affecting your AF. It’s best to discuss it with your Electrophysiologist.
I have been told by multiple doctors that .. for me... almost passing out is the result of your heart stopping to try to put itself back into sinus rythmn. Since I had a period of multiple shutdowns within a few hours while I was hospitalized , I now have a pacemaker to insure that my heart restarts. It does not pace my heart. All of the heart stopping was caught on EKG. So they are sure of the cause (They say)When the batteries died on the pacemaker, I had episodes of my heart stopping again. It still stops with pacemaker but is started again after 2 seconds, so I don’t notice it....
"An abnormally fast heart rate (tachycardia) also can cause low blood pressure. The most common example of tachycardia causing low blood pressure is atrial fibrillation (Afib). Atrial fibrillation is a disorder of the heart characterized by rapid and irregular electrical discharges from the muscle of the heart causing the ventricles to contract irregularly and (usually) rapidly. The rapidly contracting ventricles do not have enough time to fill maximally with blood before each contraction, and the amount of blood that is pumped decreases in spite of the faster heart rate."
In my case, when I was in AF, I did notice a decrease in blood pressure. From the above excerpt, it appears that the unfilled ventricles pumped out less blood causing lower blood pressure, if I have interpreted the information correctly.
Many thanks Cuore. Its the most detailed article that I've ever seen on low blood pressure. It's going to take some time to review and absorb content...
Hi Vince 1001, I am similar to you! My BP is usually around 100/64 with HR 55 bpm....When I go in afib the same happens, the BP drops and the heart rate increases. My EP (a top Professor) says my BP and heart rate is very good.Whilst I don't have specific answer, he seemed to understand that this was to be expected
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