Beta Blockers after Stents but no HA.

I am wondering if it is the norm to just put patients on Beta Blockers? Obviously I am going to see my GP but I am a bit fed up with the side affects of them and wonder if I actually need to be on them. I didn't have a HA, and the Echo showed my heart to be undamaged and working completely normally. I now have no Angina symptoms at all and feel fine apart from the effects of the BB's. From what I have read and been told I can't really see why I am on them, is there anyone else in a similar situation?

[Chappychap]

I had a bypass rather than stents, but like you I'd not had a heart attack and there was no sign of any heart damage.

I'm on a beta blocker, and statins, ramipril, and the rest of it. But I'm delighted to be on those medications, side effects or not.

The reason is that you and I both had heart disease before our procedures, and we still have it now. We haven't been cured, just granted a stay of execution. Without lifestyle changes and medication our disease will progress, which means more stents followed by a bypass. Unless of course the heart attack that we've so far dodged, comes back to claim us first!

[Hidden in reply to Chappychap]

Good points. I am very happy as well, I can assure you! I watched my Dad suffer many years ago from the same problem, with no real help to be honest, certainly not by today's standards. I totally get the point about not being cured, and believe me I have altered my diet and lifestyle very much, not that it was that bad before. As Ashleigh has pointed out, I guess there are probably other reasons that I had not thought of.

[jimmyq in reply to Chappychap]

I had 4 CABGs before stents were in wide use, 1997, when I was 41. If you are considering life style changes, I recommend that you watch the film "Forks Over Knives". It will show you that you can clear out your arteries. It is on Netflix and YouTube. It is about global medical research, including a massive study of 800,000 Chinese people. You might find it helpful, I did.

The ideal BP is below 140/90. Mine has been as high as 240/140 but went down to 190/100 with treatment in 2016. I still had a mini-stroke in 2017 though. My BP is now 120/80. I keep a record and these are the averages, rounded up.

The ideal cholesterol is below 5. Mine was 6.5 for years, nothing budged it until this diet. It is now 3.7.

My weight was 14.5st and is now 12.5st, the same as when I was in my twenties.

I have been on a Whole Food Plant Based (WFPB) diet since March 2018 and the evidence of my blood pressure, cholesterol and pulse (50-60) indicate that my arteries are clearing. So, it took only 8 months. My doctor is gradually taking me off all the meds, the diuretics and statins have gone. Bisoprolol next, because of allthe side effects.

[Chappychap in reply to jimmyq]

"the evidence of my blood pressure, cholesterol and pulse (50-60) indicate that my arteries are clearing."

Jimmy, I can't let you get away with that. It's categorically untrue to say these metrics prove a reduction in the plaque levels within your arteries, which is what you seem to be implying. To say your arteries are actually clearing would require at the very least a flow test or even better a calcium test.

I don't want to get into the diet debate, which seems to excite fundamentalist degrees of fervour! But if lateguitarist wants to explore diet options he should also look at low carb/keto and fasting as alternatives to plant based, the adherents of each have no trouble finding evidence to support their positions!

[Hidden in reply to Chappychap]

I don't want to get into a diet debate, but I know one thing - fasting is a crazy option. it never ceases to amaze me why people go on madcap unsustainable diets, when all they need is a properly balanced food intake, with MODERATE proportions. I have watched FOK, it's got some very impressive points, certainly the meat aspect, but I think we should take the narrowing reduction with a pinch of salt - well, a small one anyway

[jimmyq in reply to Hidden]

This isn't fasting, far from it. I eat a lot but it is all healthy stuff. Lots of veg, fruit, beans, nuts, salads, etc. No animal products, dairy, eggs, processed food or junk food. Very little salt. My health is improving and all my wife's life-long allergies have disappeared.

[jimmyq in reply to Chappychap]

If my arteries were still blocked my Blood Pressure would still be raised. A doctor advised me of this.

[Chappychap in reply to jimmyq]

Jimmy, I appreciate you hold your views with a grip of iron, and nothing I say is likely to change them. But for anyone else reading, consider this.

I had a bypass six weeks ago, my blood pressure, has fallen massively from around 145/95 to around 110/70. However I have not yet changed my diet, all that's different is I've started taking medication. Medication can massively reduce blood pressure, even if your arteries are totally unchanged!

Incidentally, another area where I'd take issue with Jimmy is in what constitutes the ideal blood pressure. Jimmy said ideal blood pressure is below 140/90. As far as I know anything above 140/90 is considered high, but the "ideal" blood pressure is actually between 90/60 and 120/80.

[jimmyq in reply to Chappychap]

Hi Chappychap, I take your points on board.

Firstly, as evidence of my arteries clearing my BP is currently reading as 120/80.

Secondly, the only medication I am currently taking is Clopidogrel to reduce the stickiness of my blood. So my BP is at the "ideal" level without BP medication.

The medications I was taking previously may have saved my life but, thanks to the diet, I don't need them now. I would like to come off the Clopidogrel too, eventually, but I don't seem to be getting any side effects from them so I will stick with them for now.

I am "talking" about my experience. It may not work the same for everyone but I want to help people by giving the information and I hope it works for them too.

I don't hold these views with such a grip, I am constantly researching and reviewing them but keep coming back to similar conclusions.

I am not a doctor. I am not telling anyone to ditch the meds. I suppose I am advising to take the meds and do waht you can to improve your health yourselves. When my doctor started me on BP meds in 2016 I asked if there was anything I could do myself. He said that diet and exercise would reduce BP but no-one will do it. So I swore to do it.

[controlcause in reply to jimmyq]

Did you measure plaques via ccta or cimt ? Reduction of BP is good but artery cleaning might be much more complex subject

[jimmyq in reply to controlcause]

My BP, cholesterol and heart rate are all down. I admit that isn't proof but if my arteries were still blocked they would all be up.

[Ashleigh_BHF]

Hi Hidden

Yes it may be appropriate for you to start beta-blockers after having stents but no heart attack. Depending on the level of coronary artery disease you have, your cardiologist may feel it's appropriate for you to start them. Beta blockers work by blocking adrenaline and noradrenaline from binding with your heart muscle cells, and by blocking these hormones it reduces the strain on your heart muscle. For more information on beta blockers, please see our page here:

bhf.org.uk/informationsuppo...

Take care,

Ashleigh

[Hidden in reply to Ashleigh_BHF]

Yes of course, I had not thought of that. The trouble is, it's very difficult to get carried away and believe you have been "cured", when in fact you have only been given another chance, if that is the correct way of putting it! Thanks for your reply!

[Ashleigh_BHF in reply to Hidden]

Hidden very true! As you now have stents, doesn't mean the coronary artery disease has disappeared. Your cardiology team will put you on the right combination of drugs to help reduce the strain on your heart, and slow down the progression of coronary artery disease in the future to keep you healthy. Great to read above you are taking steps to change your diet and lifestyle! If you have any questions or want to chat to a cardiac nurse for more information, call us on 0300 330 3311.

Take care,

Ashleigh

[Hidden in reply to Ashleigh_BHF]

Brilliant! thank you. Changed man here.....now Pescetarian with the occasional chicken breast, no butter, cream or other diary apart from Semi skimmed milk in tea and a bit in morning porridge. Cut out all the biscuits and cake that were only an occasional treat anyway, along with chocolate - I was a bit of a double decker muncher now and again. I have lost best part of a stone since my procedure on 9th October, and get out brisk walking now with a bit of jogging most days. Not that I was overweight anyway, but any you can shed makes you feel better. To be honest I feel better now than I have for years, you don't realise how things creep up on you, I think I was suffering from symptoms for ages without realising it.

[Sususulio]

Just to say exactly the same position (procedure 16.10.18) and I too wondered about the Bisoprolol and similarly making some significant lifestyle changes. In some ways I feel better but in other ways not - low mood and tiredness + resting pulse of 53 is a concern. I am hoping things will even out over time I am on the lowest dose.

I found this interesting.

nhs.uk/news/heart-and-lungs...

As with everything on our new journey I suppose it’s about being informed and reassured....

[Sususulio in reply to Sususulio]

And this

onlinejacc.org/content/66/1...

Again with the caveat that we each have access to teams who know our particular circumstances and will always be mindful of their advice. I just want to feel better than I do and not get into a situation where I am taking drugs to combat the side effects of other medication.

[Hidden in reply to Sususulio]

I have just taken mine in response to your reply - BP is 114/71 and resting pulse 35. My pulse was always low before though. I have still not got used to getting up slowly and suffer constant light headed feeling although it quickly passes. I came off Ramipril due to feeling pretty rough some mornings with low BP. I don't think your resting pulse is anything to worry about? I have to say though that my mood has been very good - I consider myself very lucky that nothing more serious happened during one of the worst Angina sessions and that they were able to stent both of my 95% blockages during the investigative Angiogram, and that I am able to exercise increasingly. Just think of the poor people who never got as far as us? my Dad was one of them years ago when there was nothing they could really do.

[rakeman in reply to Sususulio]

I had stents in mid July and after a discussion with my Dr I came off Bisoprolol as it made me so dizzy when ever I tried to do anything physical, pulse at rest now only 55/65.

[Sususulio]

Oh yes I totally agree and whilst we have common experience we all have to chart our own way through - just takes some adjustment - (resting pulse is only a concern to me). Again like you my treatment was prompt, I hadn’t been diagnosed with angina even and I guess some of the low mood has been as a result of the shock.

I agree with you many of my ‘symptoms’ had been there all along just never recognised as such - we’ll get there!

All the best

[Nathan53 in reply to Sususulio]

Hi Susie The only point I would add to those already made is around side effects to medication. The standard drugs regime that most of us are prescribed undoubtedly have a beneficial effect and target the problems we have. I was prescribed the usual group of: aspirin, bisoprolol, Atorvastatin, ramipril, ticagrelor. I persisted with all meds for 5 months trying to work through debilitating tiredness every afternoon in particular. My condition did not really dictate the level of tiredness I was feeling. I suspected that bisoprolol was indicated after reading research on how it can affect some people. I say some people as many have no problems. I asked to try a different category of beta blocker - one Dr told me that all beta blockers would cause some degree of tiredness but my Cardiologist agreed to my wish to swap and try Nebivolol. Within days the tiredness just went and hasn't returned. Now I have seen posts on here where people didn't like Nebivolol - what suits one person won't suit another. My point really is that although we can't always eliminate side effects we sometimes can or at least reduce them. If you think you are not coping with a particular medication don't give up discuss it with your GP or Specialist. All the best

[jobe1968]

The European Heart Journal. ESC guidelines have excellent information regarding the drugs used in treatment of heart disease.

Well worth seeking out via the internet as it’s freely available.

I was able to review my meds after reading and raise informed questions to my heart specialist. Resulting in dropping one med as no benefit for me and it came with some pretty nasty side effects.

It’s written for doctors but is accessible to the layperson.

If you have trouble finding pm me and I will send a link. 190 pages so best no printed on a home printer.

[Clerkenweller]

It’s quite normal since they relax the heart muscle. I had an appalling reaction to them anywas taken off them.