Blood Pressure/ Heart Failure

[Prada47]

Hello

A question on Blood Pressure with Heart Failure. I have moderate Heart Failure with an EF of 40% on all the meds Entresto, Bisoprolol, Statins, Asprin, Eplerenone etc

I do have a pretty big swing in my SYS Blood Pressure from 90 to 160mmHg anyone else have these swings and any reason for it ? I think that's my question anyone know a reason for these swing ?? I was wondering if the chamber is not emptying properly then the next beat causes the Higher Pressure ?

Just trying to understand what is going on, I do see my Heart Rate follows i.e. Higher the Pressure lower the HR.

Not unduly concerned just seeing if anyone knows the reason for these swing when on medications that are supposed to keep it stable !!!

Regards

[Hidden]

I take it that the conditions that the varying readings are taken under are pretty much the same? As in taken at the same time, same rest before, eating the same foods, etc etc.

[Prada47 in reply to Hidden]

Hello

Yes the Lower reading is Morning and the Higher one around 9 pm

I take all my meds around 8.30 with my breakfast then Second Emresto in the Afternoon and Statin at Night. Just rtying to see if anyone else has these swings and is it within a range !!!

Regards

[Neil0000 in reply to Prada47]

Hi Ive been on all the meds same as you, I've noticed that for some reason, my blood pressure goes out of control, goes up and down I've ask every doctor you can think from the bottom to the top, they have all no idea, sorry I'm not much help

[Engineer46]

Hi Prada. You are taking a number of medicines that can have similar effects but that take various lengths of time to reach their peak effect.

For example, Eplerenone can take up to four weeks to reach full effect (reducing blood pressure) and so probably has little short-term effect. In contrast, Entresto reaches full effect in a couple of hours and the effect wears off quite quickly.

I’d suggest that you try taking your blood pressure before and two hours after taking your drugs, to see if there is any pattern.

Also, some statins are not compatible with Entresto and the drug info leaflet will identify these.

Best wishes.

[Wingnutty]

I am not on as many meds as you (bisoprolol, Statin, Amlodopine and warfarin), but I have some significant variation in systolic pressure when taking readings and it is always a lot higher when at the GP practice. I am believed to have what is known as white coat syndrome which means that my BP goes up in the presence of a medic. When I take my pressure at home, I find that several readings taken one after another can vary by as much as 30 or 40mmHg on the systolic side and I am using the Omron BP monitor recommended by my GP. I also find that if I concentrate on the reading while I am taking it, then it seems to increase, so I always try to do something else while I am taking it. Typically, I will read my e-mails while taking 3 readings and after recording the first 2 just for interest, I will ignore them after taking the 3rd and use that as my reading. If you haven't tried taking several readings one after another, it would be worth trying to see if they are consistent or if they vary like mine. If they do vary like mine, then you are unlikely to find an answer as to why they do that. I think we just have to accept that there is an awful lot that is not known about heart disease and it might be that the cuff method is not an acceptable form of blood pressure measurement for certain people. Unfortunately, the alternatives for taking blood pressure are too invasive to do at home and require much more expensive kit anyway.

[Engineer46 in reply to Wingnutty]

Wingnutty, a variation of 30-40mmHg in three SBP readings taken within a few minutes looks excessive and could be due to a faulty machine. I have an Omron and the SBP variation that I see in three quick readings is always less than 10mmHg.

Have you checked the machine by getting someone else to use it and seeing what variation they get? Do you have the Omron that lets you know if the cuff is not properly fitted?

The cuff method is a pretty standard way to measure BP and it’s hard to see why it shouldn’t work effectively for you.

Best wishes.

[Prada47 in reply to Engineer46]

Hello

I am finding this interesting because I am trying to understand a little more about Heart Failure ( I do know from Cardiology that I have a Complex Coronary Anatomy ) and I was trying to get an understanding of what's going on. I took my meds 1/2 hour ago and just did 4 consecutive BP readings

Morning Readings

101/52 68 109/58 64 108/59 65 110/57 65 104/53 68 so looks like I am pretty stable shortly after Meds. I will do them again this afternoon and again tonight !!

Afternoon after a 3 mile walk with next doors Dog

121/58 76 113/62 74 105/60 76 107/68 75 108/59 76

Evening readings

134/65 61 127/70 61 117/64 63 128/66 62 110/66 68

So no alarming Blood Pressure reading just pulse gone a little higher 6 hours after 7.5mg Bisoprolol

My Heart Nurse and Heart Failure Cardiologist say I am at the Maximum for Medication and I can't progress to the next stage of Entresto. I currently take 49/51 mg twice a day and they say BP will drop to much if I move to 97/103 mg.

When on 10 mg Bisoprolol pulse dropped to 33 BPM so now on 7.5mg and no side effects !!! Pulse can be between 50/70 but on average low 50s. Thanks for your input

Regards

[Wingnutty in reply to Engineer46]

When I first got the Omron, I took it to my GP and compared my reading with the reading they got from theirs at the same time and they were fairly close, so we were both happy that it was reading OK. I'm always careful to make sure that the symbol on the cuff is directly above where the artery is supposed to be and I don't wrap it around the arm too tightly or too loosely so I don't know what I can be doing wrong. Sometimes, all three readings are close and at other times I get this large variation. This used to happen with a previous BP monitor I had, but that one was a type that wrapped around the wrist rather than the upper arm. After I told my GP about it, he asked me to get the Omron one which I did. The model I have is the Omron M2 basic by the way, which is what my GP was using. The thing about me is that nothing seems to go straight forward. I am always the unusual one where nothing seems to work the way it should. Recently spent 450 quid on varifocal glasses only to find that they were completely out of focus for long distance. Optician asked me to persevere for 10 days and I would get used to them, so I tried that and it didn't work. They eventually agreed that I needed new glasses with a weaker prescription and that I am one of the very few people that their sophisticated eye testing kit just doesn't work on. Typical me.

[Engineer46 in reply to Wingnutty]

I have the Omron M3, but the M2 appears to have the same functions. I think that the cuff should be quite secure on the arm and that you shouldn't be able to get your finger between your arm and the cuff. I always wrap it quite tightly and have only had the "wrap tightly" indicator come on once.

I'd be happy to chat about eyes privately as I have a lot of experience with varifocals and have well treated AMD. As it's off topic you could send me a private message.

[Engineer46]

Prada, those readings are indeed stable and it will be interesting to see how your BP changes at different times related to your drug regime.

Several of your drugs will reduce your BP: Eplerenone is designed to reduce BP; Entresto is designed to protect the heart but one side effect is to reduce BP; Bisoprolol reduces heart rate and therefore also reduces BP.

It sounds as if you are being well cared for and I wish you well for 2022. Let's hope that things get back to some sort of normal!