Low blood pressure

[Poorlizzie]

I was diagnosed with AF in October ( now permanent but controlled)and heart failure in December(EF 32). I am now on Bisoprolol 2.5mg, Edoxaban60mg, Entresto24mg twice daily,and new one Spironolactone25g. My problem is that my already low BP plummets every time a new drug is introduced or an increase 70/50. It has gone up to 90/70 since I spaced out the drugs during the day. The problem is that the cardiac nurse will not increase any of the meds from a low dose. I asked for another echo (last one March) and he said there was no point!

From what I have read the highest dose is crucial in raising my EF. Having been told all my life how lucky I was to have low blood pressure it is now the opposite. Anyone else out there with severe HF and low BP that is responding well to medication.

[etheral]

Hi, Iam in CHF with An EF of 23 while in afib and 34 in NSR. In afib I lapse into pulmonary edema. Fortunately NSR has been maintained with Tikosyn, a drug unavailable to you The Entresto dose could be doubled as per EPs and manufacturer reccomedation. I was on spironolactone but discontinued it because it caused elevated potassium. I wonder if your dose of bisoprolol is causing the low blood pressure. .My BP has been stable at approximately

129/80 in NSR. Hopefully you are mostly in NSR and the beta blocker can be minimized. Switching to a loop diuretic or thiazide may be helpful.. Why is your EF so low? Anyhow an appointment to discuss all this would be in order with your your EP. 70/50 soundsl

low enough to be symptomatic. Make sure your sodium is WNL. Best of luck in a difficult situation..etheral

[etheral in reply to etheral]

PS, rereading youth post I see that you are in permanent AF.I would hope all possible measures have been taken to convert you to NSR including potentially dangerous drugs such as flecinide pr Amioderone. etheral

[Poorlizzie in reply to etheral]

Thanks for your reply etheral. Cardiologist said I probably had AF for a long time and it would not work. As regards the Entresto I was told my BP was too low to increase it. I had felt so much better when it was first prescribed I would like to have it increased . Nurse just added spironolactone which makes me feel terrible. Beta blocker was reduced when my heart rate went under 40. Not due to see the cardiologist until the end of October. I am in permanent AF but have no symptoms . I have to see a Pharmacist at the end of the month who is taking over my perscription medicines I will see if she can increase my Entresto.

[Ewloe]

I’ve had trouble with my low BP. Especially at first with the medication. Bisoprolol and ramipril are the main culprits. They tried to get me up to 10mg bisoprolol 😂😂. I got to 7.5mg and could barely walk because my BP was so low. 70/40 I now take 5mg but divided into 2 doses. Morning and bedtime. I take ramipril at bedtime as well. I still have to make sure I drink plenty and eat on time otherwise my BP and pulse slither downwards.

[opal11uk]

Hi Lizzie, sorry to read your post, I know how you are feeling. I too am in H/F and was in permanent A/F, thankfully the cardio practitioner managed to balance my meds and I have regained some of my former strength, the breathlessness and edema has been controlled. I currently take 10mg daily Bisoporal in the morning with 20mg Fusimide and 250mg Disopyramide at night and my stats have gone from 107/79 H/R 111 to 120/83 H/R 63 however I do have a Pacemaker to stop my H/R going lower that 60. If your cardio is unwilling to try and help you further it might be an idea to go to another who will as heart failure properly controlled can extend life and make you feel more comfortable, furthermore don't let the term frighten you, it just means your heart is not working quite as well as it should. Good luck x

[Poorlizzie]

Thanks Ewloe for replying. Interesting what you said about eating on time. I have not been able to exercise much and my appetite has suffered so I have been a bit lax as regards mealtimes. I will pull my socks up and make sure I eat more regularly and see if that helps