High blood pressure and low heart rat... - British Heart Fou...

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High blood pressure and low heart rate, what do I need to know when talking to my Dr?

Elliedot01 profile image
Elliedot01

Hi there, this is my first post, I am after a bit of advice but I don’t want to seem like a twit! I am a 53 year old female, I have seen the Dr for high blood pressure and heart palpitations. I heave been feeling rough for ages but delayed seeing the Dr for all the usual reasons. Anyway, I have blood pressure reading from a home bop monitor that varies between 135-160ish (a few either side of this) / 80-95 (few either side of this). I realise this is not really dangerous except I have a low resting heart rate of 44ish, dips to 32 when I am asleep.

For additional context I am a runner, do Pilates and yoga so I am fit. My weight is 8st and 5ft3.

I have had blood done, the FTC and kidney? Had to be redone and now the Dr has arranged for a phone app in two weeks to discuss. What questions should I be asking, I am a little worried the dr will discount the low heart rate bit and prescribe blood pressure meds and send me on my way. Of course you may tell me this is the correct approach but I am worried.

21 Replies

Normally the heart would slow down to lower high BP.

Have you had an ECG to check why your HB drops so low?

It could be that you have 2.1 or 3.1 AV Node heartblock where your atria beats normally but not all the P waves flow through to the ventricles.

If your bradycardia comes on suddenly and reverts back to normal just as suddenly then the above is likely.

The Sinus Node can also slow down for some unknown reasons with the Atrials and ventricles beating in normal synchronisation.

There is no tablets for this so a pacemaker is probably required.

My HB drops suddenly to 32 bpm so I am strangely looking forward to a pacemaker. This will relieve me of fatigue, breathlessness and tablets.

Elliedot01 profile image
Elliedot01 in reply to Palpman

Thank you so much for this reply. When I took my bop this morning it was 162/92 hr 45, I have just been for a 10k (hard effort called a tempo run) run and took it again, about 20 mins after getting back it was 119/72 hr68. The hr is generally in the 40s and 50s when sitting it spike up to 90s and 100s when I move around.

I hope the Dr took on board the low heart rate stuff because I am not certain she did. I had a heart check thing with electrodes for a few mins when I was at the surgery.

have you also had your thyroid checked?

I am not sure, I think just the TSH, not the T4and T3. I will ask at my appointment.

A few points -

1) Till the high BP and heart issues are sorted, I suggest that you hold off doing yoga and pilates. These two activities are not advised if your BP is high and or you have a heart condition.

2) A slow heart rate can cause palpitations.

3) Runners do tend to have low heart rates and have no problem as they are fit. However, if there are symptoms, then you should get it looked at.

4) Definitely have your thyroid tested. It could affect BP and hypothyroidism can cause a slow heart rate.

5) Resting heart rate 40s 50s spiking to 90s 100s when moving around, not doing anything strenuous, warrants getting it checked out.

Best wishes.

Elliedot01 profile image
Elliedot01 in reply to ling

Thank you so much for this useful reply. I will be gutted to drop the yoga and Pilates but if I have to then of course I shall. My heart rate has always been slow even before I took up running, not sure my fitness regime can take too much credit!

ling profile image
ling in reply to Elliedot01

Yes, please stop the yoga and pilates till the BP and heart issues are sorted out. The consequences are not worth it.

What was your heart rate before u took up running?

Yes, I've heard of this TSH issue. Maybe you can check how u can get testing done outside the system? You can ask at the HU thyroid UK forum as per below. Apologies I am unable to advise you as I'm not in the UK -

healthunlocked.com/thyroiduk

Untreated hypothyroidism can cause a slow rate. If your heart rate is already low, being hypo could slow it further. The good news is, if the high BP is due to being hypo, once the hypothyroidism is corrected, the BP can return to normal.

Anyway, not to jump the gun. Have the relevant tests done and then a proper diagnosis can be made.

Best wishes.

Milkfairy profile image
MilkfairyHeart Star in reply to ling

Hi Ling,

Are you someone living with high blood pressure and a heart condition?

Could you please provide some research based evidence to support your comment.

'Yes, please stop the yoga and pilates till the BP and heart issues are sorted out. The consequences are not worth it.'

There are studies that show practicing yoga actually reduces a person's blood pressure.

I have practiced yoga for many years without any problems. I adapt the poses with advice from my yoga instructor to suit me.

I slowly move from one pose to another and try not to keep my head below my heart for too long.

Chair yoga is another option.

My Cardiologist actively encourages me to keep up with my yoga as it is so beneficial, he practices yoga himself.

Elliedot01 profile image
Elliedot01 in reply to ling

My heart rate has always been slow. My grandfather and father both died from heart attack t 58 and 60.I assume running is still ok, it increases my hr so decreases my blood pressure.

Thanks for the continued replies.

ling profile image
ling in reply to Elliedot01

What was the cause for the heart attacks? If u know that, then perhaps that's one direction u can start checking from.

Brisk walking is also good.

Elliedot01 profile image
Elliedot01 in reply to ling

I don’t know in both cases was sudden and not expected.

84green profile image
84green in reply to Elliedot01

I have heart disease (classed as mild). No heart events or procedure. I also have a leaky aortic valve. My BP is around 125/70 (with 5mg Ramipril).

I specifically asked my cardiologist about exercise. I also do Pilates, run and walk as my aerobic exercise. He said these were all fine. He also mentioned that people with high BP should avoid heavy weights.

Several people have “low” HR’s (mine is generally between 47 - 53 when resting) but goes up and down with activity as expected. In my experience, drs focus more on the symptoms than the numbers. Do you feel light headed, short of breath, fatigued, any chest pain?

I would suggest you discuss your fears with the GP and maybe ask for an ECG (to check your heart’s electrical activity) and an echocardiogram (to check heart structure). This can help put your mind at rest or identify any issues that need treating. You can also get these done privately if you want.

Good luck

ling profile image
ling in reply to 84green

Do you have any symptoms from the leaky aortic valve?

Thank you

84green profile image
84green in reply to ling

Hi Ling

It’s classed as moderate as of last month and I currently have no symptoms. The reason I mentioned my exercise routine to my cardiologist was I wondered if it might have an effect on the valve. He thought not and stressed the many other benefits of excercise. I aim for an hour of moderate activity a day.

I have a friend. whose first indication of his aortic valve problem was when he collapsed on holiday. Flown back to the uk and valve fitted ASAP.

Best wishes

ling profile image
ling in reply to 84green

Wow it must have been serious to cause a collapse. Thank you very much for sharing.

Yes, doctors always stress the benefits of exercise.

Best wishes.

Elliedot01 profile image
Elliedot01 in reply to ling

Very interesting, thank you for such an in-depth account. I hope my practice is low risk ,no headstands or complex positions for me! I am firmly in the beginner stages and there re very few inversions in my routines, I will have to chat with my teacher when classes resume.

ling profile image
ling in reply to Elliedot01

On and off, there are news reports, health documentaries, and even here on HU forums, where people talk about suffering strokes and heart attacks while doing yoga or pilates.

These exercises that involve stretches and bends that contort the body into stressful positions, are not suitable for everyone. And as our bodies age, we should be ever more mindful and cautious.

Milkfairy profile image
MilkfairyHeart Star in reply to ling

Ling there are many different types of yoga.Many of the examples you give are extreme practices that are certainly not suitable for many.

I would not for example ever do a headstand! Nor would my teacher.

It is important to only adopt poses that are suitable for you as an individual after discussion with your Cardiologist and teacher.

It is important to check that your teacher is aware of any health issues before you start.

Your teacher should also have completed the appropriate approved training and have indemnity insurance.

I find your views alarmist and potentially unhelpful causing some people to be worried unnecessarily.

To help give a context to your answers can I ask once again what your lived experience of heart disease is?

Do you practice yoga? 🧘‍♀️

ling profile image
ling in reply to ling

When we live with various medical conditions, we need to think things through and decide if certain exercises are suitable for our bodies.

Sharing here an in depth article regarding yoga -

How Yoga Can Wreck Your Body

nytimes.com/2012/01/08/maga...

(Please refer to the link for the full article)

... But a growing body of medical evidence supports Black’s contention that, for many people, a number of commonly taught yoga poses are inherently risky. The first reports of yoga injuries appeared decades ago, published in some of the world’s most respected journals — among them, Neurology, The British Medical Journal and The Journal of the American Medical Association. The problems ranged from relatively mild injuries to permanent disabilities ...

In 1972 a prominent Oxford neurophysiologist, W. Ritchie Russell, published an article in The British Medical Journal arguing that, while rare, some yoga postures threatened to cause strokes even in relatively young, healthy people. Russell found that brain injuries arose not only from direct trauma to the head but also from quick movements or excessive extensions of the neck, such as occur in whiplash — or certain yoga poses ...

Extreme motions of the head and neck, Russell warned, could wound the vertebral arteries, producing clots, swelling and constriction, and eventually wreak havoc in the brain. The basilar artery, which arises from the union of the two vertebral arteries and forms a wide conduit at the base of the brain, was of particular concern. It feeds such structures as the pons (which plays a role in respiration), the cerebellum (which coordinates the muscles), the occipital lobe of the outer brain (which turns eye impulses into images) and the thalamus (which relays sensory messages to the outer brain). Reductions in blood flow to the basilar artery are known to produce a variety of strokes ...

In 1973, a year after Russell’s paper was published, Willibald Nagler, a renowned authority on spinal rehabilitation at Cornell University Medical College, published a paper on a strange case. A healthy woman of 28 suffered a stroke while doing a yoga position known as the wheel or upward bow, in which the practitioner lies on her back, ...

The experience of Nagler’s patient was not an isolated incident. A few years later, a 25-year-old man was rushed to Northwestern Memorial Hospital, in Chicago, complaining of blurred vision, difficulty swallowing and controlling the left side of his body. Steven H. Hanus, a medical student at the time, became interested in the case and worked with the chairman of the neurology department to determine the cause (he later published the results with several colleagues). The patient had been in excellent health, practicing yoga every morning for a year and a half. His routine ...

Hanus and his colleagues concluded that the young man’s condition represented a new kind of danger. Healthy individuals could seriously damage their vertebral arteries, they warned, “by neck movements that exceed physiological tolerance.” Yoga, they stressed, “should be considered as a possible precipitating event.” ...

These cases may seem exceedingly rare, but surveys by the Consumer Product Safety Commission showed that the number of emergency-room admissions related to yoga, after years of slow increases, was rising quickly ...

The Times reported that health professionals found that the penetrating heat of Bikram yoga, for example, could raise the risk of overstretching, muscle damage and torn cartilage. One specialist noted that ligaments — the tough bands of fiber that connect bones or cartilage at a joint — failed to regain their shape once stretched out, raising the risk of strains, sprains and dislocations.

In 2009, a New York City team based at Columbia University’s College of Physicians and Surgeons published an ambitious worldwide survey of yoga teachers, therapists and doctors. The answers to the survey’s central question — What were the most serious yoga-related injuries (disabling and/or of long duration) they had seen? — revealed that the largest number of injuries (231) centered on the lower back. The other main sites were, in declining order of prevalence: the shoulder (219), the knee (174) and the neck (110). Then came stroke. The respondents noted four cases in which yoga’s extreme bending and contortions resulted in some degree of brain damage ...

In recent years, reformers in the yoga community have begun to address the issue of yoga-induced damage. In a 2003 article in Yoga Journal, Carol Krucoff — a yoga instructor and therapist who works at the Integrative Medicine center at Duke University in North Carolina — revealed her own struggles. She told of being filmed one day for national television and after being urged to do more, lifting one foot, grabbing her big toe and stretching her leg into the extended-hand-to-big-toe pose. As her leg straightened, she felt a sickening pop in her hamstring. The next day, she could barely walk. Krucoff needed physical therapy and a year of recovery before she could fully extend her leg again ...

But (yoga pose) modifications are not always the solution. Timothy McCall, a physician who is the medical editor of Yoga Journal, called the headstand too dangerous for general yoga classes. His warning was based partly on his own experience. He found that doing the headstand led to thoracic outlet syndrome, a condition that arises from the compression of nerves passing from the neck into the arms, causing tingling in his right hand as well as sporadic numbness. McCall stopped doing the pose, and his symptoms went away. Later, he noted that the inversion could produce other injuries, including degenerative arthritis of the cervical spine and retinal tears (a result of the increased eye pressure caused by the pose). “Unfortunately,” McCall concluded, “the negative effects of headstand can be insidious.”

Almost a year after I first met Glenn Black at his master class in Manhattan, I received an e-mail from him telling me that he had undergone spinal surgery. “It was a success,” he wrote. “Recovery is slow and painful ... The injury, Black said, had its origins in four decades of extreme backbends and twists. He had developed spinal stenosis — a serious condition ... Black said that he felt the tenderness start 20 years ago when he was coming out of such poses as the plow and the shoulder stand. Two years ago, the pain became extreme. One surgeon said that without treatment, he would eventually be unable to walk ...

I asked him if his recent injury could have been congenital or related to aging. No, he said. It was yoga. “You have to get a different perspective to see if what you’re doing is going to eventually be bad for you.”

“Yoga is for people in good physical condition. Or it can be used therapeutically. It’s controversial to say, but it really shouldn’t be used for a general class.”

Elliedot01 profile image
Elliedot01 in reply to ling

Thank you again for the info, very interesting. I think my practice is most likely safe, no headstands or complex moves. I am very must an entry level down dog and cat cow type with the occasional plank and warrior pose. I will keep in mind what you say. A bit of a scan suggests the problems induced are not related to the heart though?

Elliedot01 profile image
Elliedot01 in reply to ling

With the thyroid it seems really hard to get a GP to do the full range of thyroid tests if the TSH is within tolerance. I will need to wait to see what she says at my phone appointment.

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