Anyone else noticing your HR kick up in this heatwave we are having ?

[Turquoise19]

would appreciate shared experiences

[BobD Volunteer]

Of course. Your heart has to work harder to try and keep your body cooler. Quite normal. Interestingly I also find my BP lower no doubt because all the blood vessels expand to do similar. (pressure falls with increased volume. )

[Turquoise19 in reply to BobD]

Thanks Bob, I hadn't thought about it as needing to work at keeping me cooler. Too busy thinking about pathology. So don't like it when my HRV based monitor for stress goes up. am alsobin the process of cutting my beta blockers down. But slowly so as not to strain it.

Just reminding me I still have a lot of fitness catching up to do.

Interestingly tho, after a coldish shower last night it went down to my normal. N then, this pm after air conditioned shopping at Tescos it went right down to 40 odd then kicked right back to 60/65 half hour after getting home. My norm is around 55

My GP said about the BP going down when it's hot.

[Ducky2003 in reply to BobD]

My BP and pulse both drop. Pulse dropped to 38 night before last.

[Hidden]

Hi,

Yes mine has.

Thing is I have cut back my Bisoprolol dose to a lower amount because my resting heart rate has been far too low - 40 ish to 58 ish whereas I function best at 64 ish to 72 ish. So, heatwave not withstanding, I am delighted at the higher HR - currently around 57 to 64 ish. Apart from that totally agree with BobD .... also as with Bobs comments .... my BP is lower too.

John

[Turquoise19 in reply to Hidden]

What is Yr understanding John on why your HR goes so low ?

[Hidden in reply to Turquoise19]

Hi Turquose,

From the evidence so far it is the side effects of an increase dose of Bisoprolol from 5mg to 7.5mg. When diagnosed with paroxysmal AF in Jan 2010 my Cardio Consultant put me on 5 mg Bisoprolol at a time in history when Bisop was widely regarded as a rate control drug - and it did the job v well.

In Jan 2021 my GP increased my Bisop to 7.5 mg in response to BP being a tad high. I suspect my body initially accepted it but now after a year or so is rejecting it - read my current issues in italics.

For me Bisoprolol is no longer an appropriate drug for HR control (actually it really doesn’t do much for BP either) without debilitating side effects, namely: feelings of intense coldness, at extremities and through limbs to the bone; brain fog behind the eyes; resting HR far too low falling in range 41 to 58 bpm; runny nose particularly when having a meal, stuffy nose, coughing fits; tiredness beyond just extreme fatigue and increasing incidence of nightmares and sleeplessness.

These days in the current era Bisop seems to be being used as a wonder drug for BP control. NOT FOR RATE CONTROL. For goodness sake, I'm already on Ramipril and Felodopine for BP control anyway !!!

It should also be said that in 12 & half years my party bag of drugs has never been reviewed - that changes on 1 Sept when I meet my Pharmacist for the said review.

I have on my own initiative began cutting back my Bisop, initially by 1.25mg a day over 10 days, now by a further 1 mg a day until 23 August at which point I'll resume 5 mg a day ( taken at night). Thus far my HR is picking up as I have described.

John

[Turquoise19 in reply to Hidden]

Interesting John, I am now down to 1.25mg bisoprolol. Was 10mg pre ablation in Feb. EP happy for me to come off totally.

I never really had side effects from Bisoprolol apart from weight gain and restricted exercise threshold but had to slow off that anyway. Now still finding it hard losing weight n getting fit again.

My HR was up higher over night last night. Around 60bpm so still 'normal'. My norm still is around 55

[Auriculaire in reply to Turquoise19]

Our bodies are programmed by evolution not to like weight loss - they cannot tell the difference between self imposed diets and the start of famine and will lower the metabolic rate in response to fewer calories. I think probably the best way to trick the body is to make sure that all the calories consumed are from highly nutritious foods and cut amounts very slowly so as not to send it into a panic. Weight gain from drugs or untreated hypothyroidism is particularly insidious.

[pusillanimous in reply to Hidden]

Interesting - I take Biso when needed, when my heart rate goes over 100bpm, I take 1.25mg and my heart rate rapidly reduces, but I don't like it too low! I take 10mg Lisinopril and 120mg Verapamil for BP. The Biso does make my blood pressure lower than one would consider normal (I do not have any fancy gadgets for measurement, as that would turn me into a full blown hypochondriac,) just a couple of simple wrist BP monitors and and finger oximeter, I cannot use the cuff type upper arm BP monitors as I have thin arms and I just can't place them properly. However, with the lower blood pressure I do not have any undesirable symptoms, so I don't think it's a problem.

[Belle11 in reply to Hidden]

Thanks for this. I have some of the symptoms you describe too, and others - pulse from 39bpm, often 43 or 44, to upper 50s sometimes, runny nose, fatigue, shortness of breath on walking, ankle swelling, a general felling of being slowed down and tired, plus a return of the psoriasis I had had in remission for years.

I've lowered my carb intake, and think that has helped to some degree with ankle swelling, and have finally got agreement from the cardiologist and GP to lower my dose gradually.

I couldn't lower my dose to 8.75 by myself, as it seemed impossible to divide a 10mg tablet accurately. How do you manage it?

[Hidden in reply to Belle11]

Hiya Belle,

Well I'm sorry to say but its nice (having read your response) to know that I'm not Robinson Crusoe.🙂with my symptoms.

OK, so here is my explanation ..... I have my final supply of 7.5 mg Bisoprolol and I have 2.5 mg too - both are on my online repeat prescription list. So, I just order what I want.

Next I bought a pill cutter (off Amazon UK)

Next - I cut my 7.5 mg in half giving me two 3.75mg portions. One portion is rewrapped in its foil and the other in baking tin foil ready for use. I prepare my weekly meds doses on a Sunday for a week. Each pill compartment is labelled Monday, Tuesday etc. That way its is a daily chore that I cut out especially if I'm working.

Next I take the half portion of 7.5 (thats 3.75 ) and add to it 2.5 and hey presto there is my 6.25mg of Bisoprolol.

Because of the well known recommendation of reducing or cutting out Bisoprolol v slowly I do the following.

Next step is to alternate my dose during the week ------ so starting Sunday (14th) I take 2 x 2.5 mg = 5 mg for Monday 15th I then tookmy bog standard 6.25 as per the above formula .... Tuesday 16th I go back to 2 x2.5mg for 5mg, Wed the same as for Monday etc etc. ..... by Saturday 20th my weeks consumption - 38.75 mg of Bisoprolol divide that by 7 and its an average daily dose of 5.54 mg of Bisoprol per day. I MIGHT ADD THAT THIS IS A TECHNIQUE MY INR CLINIC USES TO ADJUST MY WARFARIN WITHOUT GOING OVERBOARD.

The plan next is to keep this dose up until 23 August when I'll then cut back a nice simple old 2 x 25mg dose (5mg) of Bisoprolol. TBH, its a bit of a Faff BUT - gets results and my HR is coming up nicely even managed a 10 hr bus driving shift yesterday in the heat - no side effects. Then on 1 Sept I have a full medication review with the boss honcho Pharmacist.

Yesterday Mrs Carneuny hand delivered a hardcopy note to my GP explaining what I've just written above. I find telephone calls to my GP surgery a waste of effort, the new e-Consult system isn't appropriate and there is no way to send emails. Apart from which there is nothing like a good old ancient, primitive hand written letter duly dated and signed in ink !

So if you are on 10 mg cut it in half = 5 mg: then take a 2.5 pill: then cut a 2.5 mg in half = 1.25. so your maths becomes ..... 5, 2.5, 1.25 = 8.75mg per day .

Mind you all that said ....... Bisoprolol comes in a wide range of doses denominations, i.e from 1.25mg and upward I think to 20mg (Gosh that'd be enough to wipe an elephant out). I think many doses increase in units of 1.25, i.e 1.25, 2.5, 3.75 ?, 5 mg and upwards. A check on Bisoprolol on line would confirm all this.

Any questions on the above ask away. Good luck.

John

[Belle11 in reply to Hidden]

Thank you very much John - this is really helpful, and I shall save your message to refer to. I too ended up writing a letter to my GP which my husband delivered! For 2 years I've been asking to try a lower dose of biso without success, and saw a different cardiologist this summer, who was at first also unwilling to lower my dose - I was in my 70s what could I expect but to be out of breath after walking a couple of hundred yards, he seemed to be saying! Then he saw my pulse was 44bpm, and wrote to my GP recommending I went straight to 7.5mg and then 5mg. But having read here about the wisdom of reducing slowly, I thought it would be better to try 8.75mg first, Like you I've found telephone calls not successful - they often seem to get misquoted to the doctor!

I hadn't thought of alternate days of different doses though. I still have plenty of 10mg doses left, so I shall try the alternate days of 10 and 8.75mg for 10 days before lowering further - is that right? So then I could do straight 8.75mg doses for the next 10 days? And repeat with 8.75mg and 7.5mg for 10 days after that if all goes well (and if I can get some 7.5mg or 5mg + 2.5mg pills prescribed.) Does that sound about right?

Good luck with your own downward dosing.

Belle

[Turquoise19 in reply to Belle11]

My arrythmia nurse suggested alternative days at a higher dose, to settle ectopic beats when I was having a spate of them. While also reducing bisoprolol from 10mg post ablation.

EP was happy for me to come off in one go. Am now just about doing ok on 1.25, having used the pill cutter for 1.75 titration down, at someone else's suggestion in here.

[Belle11 in reply to Turquoise19]

That's really encouraging Turquoise. This forum is brilliant!

[Hidden in reply to Belle11]

Hi Belle,

I smiled when I saw this comment of yours ........ "I was in my 70s what could I expect but to be out of breath after walking a couple of hundred yards, he seemed to be saying! "

Yeah well , I've come across that attitude too ! My GP has the duty to give me a DVLA Medical each year before DVLA will renew my bus drivers licence. Although I do less now than in the past I have this week (Mon and Tuesday) done 2 x 10 hour shifts without issue (now I have my HR back to its optimum) I'm medically fit and mentally fit, so why should I not play big toys for big boys. All down to the brain ......... use it or loose it ! ........... strokes and dementia are part of my family history - which is a huge motivator.

John

[Belle11 in reply to Hidden]

Hi John

Pleased to hear you're doing so much better and able to take on demanding shifts. It's really encouraging, and shows it's worth keeping pushing for better outcomes

Belle

[NLGA in reply to Hidden]

Hi John I am on 15mg at the moment everyone says it’s a lot apart from my GP and cardio Doctor/nurse but I feel good on it . I don’t really understand why

[Hidden in reply to NLGA]

Good morning NLGA and all .....

I think Bisoprolol is definately a drug which falls under the broad category of " Horses for Courses". It is what it is for each and all of us.

I must say all the time I was on Bisop at 5mg I was pretty much fine once the early teething troubles were dealt with. So in January 2021 in response to rising BP my GP decided to up it to 7.5mg. That too had been successful until earlier this year when I began to notice my heart rate falling. BP was still OK.

With all the Faffing around dealing with GP surgery and their 'Thought police' I couldn't be bothered so started to plan my own Bisop dose reduction. The bit of paper in the packet was quite helpful. So off I went.

To answer your last question .......... this is my second 10 day period of dose reduction and in this period I am averaging 5.5 mg. I am alternating the doses per day Sunday 5mg, Monday 6.25, Tuesday 5 mg, etc ......... so at the moment up until 23 August I'm putting down the neck 5.5 mg a day, taken at night. Then on 24 August I go to 5mg. Then on 1 Sept I have a consultation with my Surgery Pharmacist because, as I have said, I have had no medication review since January 2010. After that who knows. I am juggling all this with my new handiman tool ....... a pill cutter.

Results so far ......... very very cheering and just what I was hoping for, HR coming up nicely ......... showing a daily average of 61 bpm and I feel really good. My target is in the range 65 to 72 bpm ...... that's the point when I function best ... my optimum. And monday and Tuesday I returned to my part time job bus driving - a 10 hr shift each day - brilliant.

Hope this is of interest.

John

[NLGA in reply to Hidden]

Thank you for this detailed info I just checked my HR it’s 48 from sleeping so will do it again in a hour as like your text it needs to come up although I have no Ill effects with it this low . I am going to cut to 12.5 mg as I also have a pill cutter . It dies seem strange that I was given this dose of 10mg from hospital but as I was still breathless this was increased to 15mg but only last week I found out I had bacteria in my lungs at the time if the increase so maybe this was behind the breathing issue , it was so bad that just walking 400 yards had me feeling like I had done 2 /3 miles up hill .I saw the cardio nurse last week for the now cancelled CV but other than her no one from the hospital since my discharge on the middle of June has been in touch with me to be honest I stupidly thought I would have a cardio doctor assigned to me and maybe a monthly appointment as we now know I am not persistent AF but I do drop into AF although with little pain only that my breathing has not returned yet my asthma PF and Oxygen levels are fine . I am starting to think if the covid I had just after Christmas is behind these issues

I can’t help thinking I’m in no man’s land at the moment with help from the hospital all I have been told is that I see I’ll get a letter soon in order to pick up a heart monitor

[NLGA in reply to Hidden]

Hi John can I ask what dose your on now

[Jalia]

My heart rate quite a bit lower. Anyone else find this ??

[Turquoise19 in reply to Jalia]

Might there be other reasons for you Jalia ?

[Jalia in reply to Turquoise19]

That's what I'm thinking. Hope to speak to EP this week. It's never been so low

[Fibber222 in reply to Jalia]

Hi Jalia. My pulse has been going very slow at times. Is that the same as heart rate? My BP also has been low. All in all I haven’t been able to tolerate this hot weather despite staying indoors, pulling blinds etc. I’ve drunk a glass of coconut water each day & had the odd dioralyte as I have low sodium. Can’t wait for this to break. I’m on the South Coast,

[Hidden in reply to Jalia]

Yup, BP lower at c 110/67 when resting with HR c 58-61. No meds involved just me with a pacemaker stopping the HR from dropping too low. My BP can go lower but thats when I need to drink …. I haven’t enjoyed the heat these last few days and looking forward to a few cooler nights for some real rest.

[Turquoise19]

health.harvard.edu/blog/hea....

Found this blog helpful

[CDreamer]

We are all so used to rushing around everywhere that the one thing we MUST all do in heat is go S L O W .

Also remember to keep up the electrolytes along with hydration. I carry a mini spray with me everywhere filled with spring water, sometimes with essential oil added, and mist myself often. Cold showers also work!

[Auriculaire in reply to CDreamer]

I have been taking it a bit easier than usual as here we have had almost continuous hot weather for what seems ages- in between heat waves the weather goes back to what are now "normal " summer temps of 27-31 ° . In the early hours of Sunday morning we had a much awaited storm and yesterday was "cold" - top temp of 22° on our balcony thermometer. My heart has behaved well for the last 6 1/2 hot weeks. Last night I went into afib! I do think that the UK is not culturally adapted -yet- for these very high summer temps. They need to look at how people who are used to living in hot climates behave and adapt accordingly - but "manyana"does not make a good fit with Protestant work ethic.

[Turquoise19 in reply to Auriculaire]

Sorry to hear you kicked back into afib. Are you still there ?

[Auriculaire in reply to Turquoise19]

No - I reverted to NSR after breakfast. My episodes don't usually last longer than 12hrs.

[gsd01]

I really suffer with the problem. Beta blockers and other medication have an adverse effect on temperature regulation and heat tolerance, so probably contribute to the higher heart rate.

[Turquoise19]

That's interesting when they are supposed to keep it down!

[Ducky2003]

Mine does the opposite. Pulse and BP drop. My pulse dropped to 38 the night before last about 3am.

[Turquoise19 in reply to Ducky2003]

That's interesting. Any idea why Ducky ?

[Ducky2003 in reply to Turquoise19]

Not a clue about pulse but I'm guessing BP same reason as Uncle Bob said.

[Jajarunner]

Your body will be working harder to keep cool so the heart will pump harder, so your BP will be up too. Anything that 'stresses' the body will do the same ie too much food, excitement,worry, heat, extreme cold, exercise etc. It's totally natural if it is not extreme xx