I see very little discussion of specific blood-pressure numbers in these posts and comments.
I understand -- correct me if I am mistaken -- that beta blockers are prescribed to reduce blood pressure, with the hope that reduced blood pressure will reduce the chances of a-fib.
So if this is the case, why is there so little discussion of specific blood-pressure numbers?
In my case, I only recently started taking my blood pressure. Over the last 10 days, my machine (who knows if it's accurate) has consistently reported in the area of 115 over 60 (pulse 55).
These numbers are much lower than what was reported a few months ago (many in the range of 135 / 90 / 78 for example). These were before I started taking metoprolol 25 twice a day.
Any opinions on that?
Even my GP and my cardiologist seem not to be concerned with blood pressure. What gives?
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Corazon17
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Yes, I see that blood pressure is not the primary forum topic. That was my observation.
It seems to be almost irrelevant to people here, perhaps because beta blockers and so forth remove *high* blood pressure from consideration.
But what I'm wondering is this: Is anyone concerned that his or her blood pressure is pushed *too low* by the meds? That is what I have not seen here, nor heard from my medicos.
Too low blood pressure has been mentioned as I recall mainly within posts but not the primary subject.
It is important to consider the average blood pressure and not necessarily infrequent drops. However, if drops are frequent and average is low and with symptoms best to discuss with your doctor.
Your doctor may recommend wearing a blood pressure monitor for a certain period to provide an accurate average.
Thank you. As for "infrequent drops," I have not noted any. Thirty readings have been amazingly consistent, almost suspiciously so.
One would hope that a doctor would do so (recommend a monitor). I guess it's up to me to make such suggestions. I guess I shouldn't expect doctors to take the lead or explain what they are thinking or suggest things to look for when prescribing meds or express an interest in seeing me in less than five months from now. Silly me.
I had this very same concern. I was taking 10mg Nebivial(Bystolic) after a severe afib episode. After changing my diet and losing 26lbs along with exercising 3 to 4 days a week my blood pressure readings were very low. Late afternoon they were lowest at like 95 over 67, HR of 50. Just before bedtime 93 over 65 HR 48, etc. I also didn't feel right as my BP was never this low in my life. I mentioned this when I saw my cardiologist and he reluctantly agreed to lower my Nebivial from 10mg to 5mg. The BP #'s are slightly higher now, still very low and when I cut the Nebivial to 2.5mg the #'s are good. Usually 115 over 67 HR 55.or similar. My readings are highest when I wake up, usually 130-135 over 80-90 area HR 66. I have CPAP machine.
I believe that BBs only lower the HR in some people and do not affect the BP, it did in my case. When I was first diagnosed with AF and sent to a Cardio, he removed my BP medication. Ever since I was placed on BP meds. I have been taking my BP,which I feel if you are only using cheap home monitors, as I do, and in my case, even worse, wrist ones as I have thin arms, is an inaccurate guide. Anyhow, after a couple of months I noticed my BP was rising to alarming levels, went to my GP who phoned the cardio and I was put back on my BP meds as well as 1.25mg Bisoprolol. When I asked her who had decided what our BP should be, she did not know, - I had understood that anything below 90/60 and 140/90 was acceptable and that 120/80, was the desirable figure. However, I then read a study by the University of Tel Aviv, I think, where they decided 115/75 should be the golden figure, but these are all for young healthy people.
I'm concerned that I'm having about 10 days of high bp 160/103 , decreasing on 2nd reading to 148/92 then waking up after poor sleep to 139/87 before taking medication. I take 1.25mg bisoprolol am and 2.5mg pm. 2.5mg ramipril twice a day. Plus Apixaban. The previous two pills were changed in July 2023 after episodes of syncope in March and July. Normally I take bp an hour after meds in morning if I feel the need. I took it at 6.50 am as I felt dizzy. I know I can't always have what I want but the feeling of about to fall over while out for a walk was frightening. Will see gp again.
This was happing to me when I was taking Ramipril 1.25mg and Propranolol, I would take them like I always do 7am Ramipril and 10am Propranolol...when I was out and about it was difficult to walk. I was feel lightheaded, eventually when I got home I would take my blood pressure and it was under 90/60...so the doctors took Propranolol away they left me on Ramipril for another 3 months before stopping it, I haven't been on any medication now since September 2023...I have a TAA or Arotic Root Ascending dilation of 40mm..From the 20th January I have to start taking Losartan potassium 25mg once on a night time at 8pm. I have to record my blood pressure readings for 2 weeks. My blood pressure at 745pm is already 115/85..so my concern is already is hopefully I won't start to feel lightheaded after a while, my cardiology consultant wants my blood pressure to be average of 135/85 below because of the dilation I have
I was taken off the lowest dose of Bisoprolol after only three days as it brought my heart rate down too low. When it was originally prescribed, I had to remind the doc that I was very sensitive to drugs ( she had wanted me to take twice as much daily) and she never arranged a follow up, but the pharmacist took my phone number so he could check after a week but after three days of feeling less energy he took my pulse and told me to stop taking them! We are all very different and it’s sad docs don’t always realise that.
I’m somebody who reads/ sometimes posts on this Forum, but got high HR and high BP as a result of Long Covid. My HR is not AFib, just regularly over 100. Had been on 5 hypertensives, but fainting, and tilt table test showed my BP plummeted to 61/40 ie postural hypotension , and it was this that drove HR up 135+ bpm. The falls specialist with TTT removed the bisoprolol, beta blocker, immediately saying it interfered with rising HR that my body needed to get oxygenated blood to the brain. And yes it is hard to find anyone on any Healthunlocked fora talking about high HR and high BP; I’ve resorted to dysautonomia sites that are largely POTS related, so tend to be young people with high HR…don’t know whether you might find Pots Uk website, or , my favourite led by a London cardiologist Stopfainting.com….not as extreme as it sounds!
The primary reason for prescribing beta blockers is NOT blood pressure but heart rate. Keeping heart rate within the normal range of 60 to 100 is deemed highly desirable in AF. Any effect on BP is incidental.
That said if BP does fall to dangerous levels beta blockers can be changed to calcium channel blockers aimed at the same result.
Remember that within the "rules " for CHADSVASC, a score can't be removed so even treated hypertenion still counts even when actual BP is wthin satisfactory levels. Note also that the latest recommendation shows that raised BP now starts at 130/75. Yes I know they have been dragging it down for years.
Yes, I mis-wrote a bit. I do know that the primary reason for a beta blocker is to lower the rate, but a side effect that perhaps is desirable is lower blood pressure. Am I correct in saying that?
And, as with other side effects, one should monitor this side effect to see where it slips from salubrious to benign to questionable to undesirable -- correct?
I do see people here describing their going from BBs to CCBs. Maybe I overlooked the events leading up to that. Perhaps this should have been my question: Why the **ck [heck] does one change from a BB to a CCB?
As for my BB, I believe it's had undesirable side effects, but I also believe that these are a good trade-off for reduced risk of stroke and so forth.
Beta blockers reduce the effects of adrenalin and have a mildly anti arrhythmic effect but can also cause breathlessness and too low BP, if so a calcium channel blocker is usually the alternative. For someone with asthma it is usually the first choice but some cardiologists are so set on bisoprolol they insist on asthmatics trying it anyway, occasionally with disastrous consequences.
I gave up any betablocker because I didn’t ultimately need it for rate control. But at the same time I did start taking an ACE-inhibitor to keep my blood pressure down to around 135/80. BP tends to rise with old age, so anything up to around 140 systolic is not regarded as a cause for concern.
I've read your post and the replies and I agree with BobD ! I was put on Bisoprolol in January 2010 and was told it was for heart rate control but that it did have some small properties that assisted with blood pressure control. It is not a blood pressure control drug. There are seperate BP control drugs that work in a different way, i.e. Ramipril and Felodopine to name two.
Bisoprolol is a drug in the family known as beta blockers - at different times my GP or my Cardio Consultant have moved me through three BB's .... Bisoprolol, Nebivolol and now currently Sotalol.
None of these drugs I've named specifically stop Afib ! They work in the back ground in different ways and if you find your Afib stops well - good luck to you. But that is not their design purpose. I just wish I could find my resource references.
I'm now 80 , have dropped Ramipril from my party bag of drugs and just scoff, Felodopine, Sotalol, and Warfarin. I take another drug but it is for a non cardiac purpose. My average BP is around 132/75 with a heart rate of around 72.
Why not ask your GP if you can tweak your dose to say .... metoprolol 25 once a day ? see what happens to your numbers, maybe metoprolol 25 x 2 is too strong for you. When do you take your metoprolol, morning or evening ? Many beta blockers work better when taken in the evening. Maybe even really push your luck and ask for a drug review with a Pharmacist. Pharmacists know more about drugs than GP's, particularly the young new breed of GP !
I take two metoprolols per day, one in morning and one in evening.
I started off with one, and then at my request went to two, on account of my heart rate going up a great deal 10 or 12 hours after taking one. My GP agreed to this, and finally, after three months of waiting, I saw a cardiologist who went along with the two.
I only recently paid any attention at all to blood pressure, and am wondering if 115-65 is a bit too low. Obviously, I will bring it up, but just wondered here if anyone has any anecdotes about their own BPs.
Yes, here an anecdote that may be interesting to some... If you ask the MDs or look in the Google, increased BP is blamed for every possible health problem people may have when elderly - from arrhythmias, to Parkinsons disease... I started measuring increased BP at the age of 45 (mildly increased, now 72 yo) but refused BP medication completely until these days. My BP was slowly increasing with the time, so 7 years ago I was caught at 190/120 when trying to get my driver's license renewed. Was prescribed the medication but put it in the drawer... Apart from cardiac arrhythmias, which I first felt at the age of 55, I have developed NONE of other possible syndromes or disease! Furthermore, I lived a perfectly active and sound life with "increased BP" because BP is not what matters so much - what is important, is blood flowrate. If the blood vessels are clogged a little, BP has to go up, in the course to maintain the necessary blood flowrate. I lived for years with the BP at the level of say 170/80 - 180/90.
Then, about a month ago, I started measuring from 190/something, to 230/100. The later was my "best ever". There were no noticeable symptoms apart from some "pressure feeling" in the head - no dizziness, no poor concentration, no problems when driving, no brain fog, no headaches, simply nothing. I remembered the medication in the drawer (Amlodipine based) and started to be medicated. The prescription was 5 mg a day. After 2 days, I started having problems when speaking and felt very slowed down. Did I need the consultation with a doctor? No, it was clear that I am overmedicated, so cut the pill in half. After 1 day, I cut the pill in 4 pieces and took it for 2 further days. Since there was a positive reaction of my BP, I stopped taking pills completely and my BP remained low, at about 165/70-75, until today.
I still measure "reduced BP" but intend to continue taking Amlodipine like 1,25 mg a week, what I already do (it had some other positive effects, which I do not dare to mention, lol).
With a consultation with MDs at 3 months interval, they are short of the feedback information about it how the medication works for you, and my personal impression is that they do not care anyway. YOU are the only one to have immediate and direct feedback, so do not be lazy to react while waiting for the consultation.
It is a true story, but do not try it at home, lol. It was my experiment, which lasted so long that it would not be possible to repeat it in this life.
I am not concerned about blood pressure that might be considered high. For decades I had numbers that some regarded as high, according to the thinking of the times, but I never took action to reduce the numbers.
But in May 2024, I did start taking meds for afib, and now I apparently have numbers that are low, and maybe too low. I think you will agree that numbers can be too *low*, right?
In any event, I am just wondering -- just wondering -- if anyone has an anecdote about a personal experience with blood pressure becoming so low that a doctor told him or her to change his or her beta blocker.
I actually have harvested one or two testimonies that people changed from beta blockers to calcium-channel blockers, but no other info was given, such as numbers or warnings of side effects from the new CCB. (Maybe it has the effect you allude to?)
As for the three months wait, I think I could whine and plead and get an appointment in one month, now that my last appointment was two months ago.
You asked about numbers, so I wanted to give a story with interesting numbers for many here.
As for too low BP, my own father lived for decades (lived until 81) with the BP 90/60. I remember the MD say "I do not understand how this man can live with such a low BP?", but he had no problems with blood circulation at all. His problems were with digestive tract. Hope it helps...
I saw Ben that you're 80 and have stopped ramipril. I know we're all different but I turned 80 in June and wondering about the odd high bp readings then relatively low ones!
As I have said my Chemist said if you are over 100 plus your age you are in trouble.
120/under 80 is crazy for a over 40 years.
I had a chart and the BP rises as the heart gets more aged. (worn).
My heart specialist was happy with my 140/75. and 75 pulse. I am 76 in Thursday.
It was the 150-160 Systollic which concerned me.
Then stroke in 2019 on no meds with rapid and persistent AF, the Dr on Stroke ward of 4 patients put me on Metopolol. ( 3 x 23.75) I said NO because in 2009 I was on 49.75 and a new Dr doubled it. I wouldn't breath.
Put back on 49.75 but in 2010 my BP went low and I was taken off it. I had lost 20kg.
On Day 4 in hospital I was diagnosed with Thyroid Papillary Cancer on a Carotid Artery Scan. They were clear but my stroke was Embolic (clot ).
The Thyroidectomy was done in 2020 4 mths later. It was a plus and 12 lymphs removed (2 affected) with dissection of the right bed.
My AF was persistent so my rapid heart rate came in No.1 importance.
The rhythm was not important.
But the Beta Blockers did not control my Heart Rate.
At 2 years 3 months the cardiac specialist left me with an uncontrolled H/Rate of 156. My Locum Dr referred me to a private Specialist. Recommended Cardiac Dr he went over my history and introduced me to a CCB calcium channel blocker.
In 2 hours my H/Rate went from 165 to 51.
So reducing the Diltiazem to 120mg CD AM and Bisoprolol to 2.5mg PM.
I have since dropped the BB Bisoprolol as my BP went low.
So the right meds are so important. Although the heart is now normal size, I have damage of a severe left atrium dilation.
My levels are now settling 115-140 . /. 75. with 75 - 80 H/Rate.
The difference of being on Beta Blocker like Metopolol or Bisoprolol is less fatigue, more energy and less sleeping.
I agree with Bob and other forum members regarding the BP being incidental. It is prescribed for rate control.
I had an ablation for AFIB in 2023. I have been free of episodes except for a couple of episodes. I did develop some sporadic SVTs and tachycardia after the procedure. I was prescribed metoprolol tartrate 25mg twice a day. The morning dose caused my BP to dip very low after breakfast which gave me a crappy start to my days. It would eventually go back to normal but it would take a couple of hours.
I requested to try metoprolol succinate (time released) which is taken once a day before bedtime. That solved the problem for me.
Yes, that's what I take, but twice a day. Which seems odd, given that it's *extended* release. I wonder if the medicos have made a mistake. Is there a type of metoprolol that is better suited to taking twice a day?
From the Cleveland clinic (yes I am in the USA): Low Blood Pressure (Hypotension)
Hypotension : Your resting blood pressure is below 90/60 millimeters of mercury (mm Hg).
I also have borderline low BP, sometimes 90/60, mild dizziness when standing or looking up. Currently 100/75, fewer symptoms. A Doctor told me one time that it is not a good idea to treat a number, treat the symptoms, so be sure to tell your Dr. about feeling dizzy. When I first started Metoprolol, I felt a little dizzy regularly when I looked up, Dr. did not change the dose, unless I split it again, it is the smallest dose here. I have been walking more, and some other things and it is better now. I have only ever taken 12.5mg Metoprolol Succinate ER (25mg tablet split in two) once a day. I switched to take it in the evening now, that way it has less effect on me during the day when I am more active. I think it makes me a little sleepy too. The Succinate type spikes the blood levels less than Tartrate. Maybe you need a lower dose too?
My pulse used to get down into the high 50s when going to sleep, now in the 60's.
My BP is about the one thing my heart does behave with so I don't connect it with the AF either. I'm on Diltiazem and that's to keep the rate down, not the BP.
My blood pressure after taking my morning meds drops to 73 over 50. Sometimes in the low sixties. I am not dizzy but totally fatigued and not able to do very much. Have reported it to various medical professionals but unfortunately when they take it( white coat syndrome) it’s 95. I have heart failure and permanent AF.Do not want to stop any drugs as they are important for my heart but do not know where I go from here.
I have low blood pressure which averages about 90/58. It does go lower at times especially after eating. It does go higher when anxious. I was told by the practice nurse not to have hot showers and if my BP goes really low and l am worried to have a cup of caffeine, either strong tea or coffee. I know that shouldn’t be done frequently with AF and only done if BP goes really low.
I can’t take bets-blockers regularly because of low BP so l just have Bisoprolol as PIP and it works for me.
I'm not really sure what you are looking for / are concerned about in the question. Obviously there is stacks of info out there in handily consumable graphics regarding BP zones. So probably isn't discussed much because of that. My understanding is that you are only considered to be hypotensive if you are below 90/60 (either of them). If you are at 115 that would be considered normal. Which country you are in - or perhaps who you talk to - may dictate at what levels they get concerned about for hypertension. At 135 that would be Stage 1 hypertension, but my understanding is that in the UK/NHS they aren't worried about that level but rather 140+. UNLESS you have had a heart attack (and quite possibly other cardiac issues as well, but I speak as post HA patient). In which case they want it sub 130.
Your doctor may well simply not be talking about it because you are in a perfectly good place. Yes it should be monitored. If it was NHS GP then probably you should have an annual review. but personally I would self monitor and then raise it with your medical team if it is going into hypo or hyper regularly.
If you have no idea whether your home machine is accurate, I'd say get another one: your uncertainty suggests it is not one you have recently acquired and so are concerned it is out of calibration. Alternatively borrow someone elses and do a cross check of readings.
The other take on this is that low BP during AFib is a concern i.e. it is one of the issues. Since I am new to this whole AF game, I have been taking readings of BP during AF episodes so that I have the data to discuss with the consultant. In case it is of use to them. At the moment though my BP has never fallen to concerning levels (which would probably explain why I'm not prone to dizziness during AF).
If you Google Dr John Bergman blood pressure, you will find YouTube presentations explaining his different idea as to why we sometimes need a higher one.
Hello my blood pressure has dropped since being on beta blockers for afib, it was good before (128 over 80) so now it is 101 over 70 sometimes a bit lower it have been told to be careful in case of falling if dizzy, my old blood pressure monitor would not give a reading any more due to the afib so I bought the new omron one from the bhf shop that gives a reading even with afib so I can check my blood pressure does not go even lower so I can flag it up if it does hope this helps
I take bisoprolol for rate control. I was on amlodipine and ramipril for high BP , when the GP increased the bisoprolol she tapered me off the amlodipine as she was concerned my BP would get too low. It's settled around the 123/ 89 mark . I monitor my own BP and have to submit readings annually for a review. I admit, I don't check it as often as maybe I should.
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Low Blood Pressure. 
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