Blocked LAD and blood pressure

[RATP]

my LAD is 90% blocked. Symptoms being controlled by drugs. Will the blockage affect my blood pressure?…

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Hello

I do believe but am not a Doctor but yes it can as your heart is having to work harder to pump the blood round but if the drugs start to do their job then your heart will be happier and hopefully your blood pressure to x

[Steve_G]

Not a medical Dr but a PhD pharmacologist who spent 35 years developing new drugs. Cardiovascular disease is a systemic disease - the LAD is one of potentially many blood vessels that have been affected. The LAD supplies oxygenated blood to the muscular walls of your left ventricle, the heart chamber that pumps blood to the rest of your body - failure, due to narrowing, to get the oxygenated blood needed to meet demand results in angina. Hypertension is a symptom of a systemic problem rather than an issue with a single blood vessel. The atherosclerosis that affects the arteries such as the LAD results in a loss of elasticity - they become stiff. This means that when the heart pumps the large arteries to the body are no longer able to bulge to absorb the shock of the pulse of blood being ejected by the heart. This loss of elasticity results in raised blood pressure. Raised blood pressure can also then lead to changes in the way the kidneys function which again can increases the hypertension. The drugs used to treat high blood pressure therefor include those that reduce the workload of the heart (beta blockers such as bisoprolol), drugs that relax and dilate the arteries (calcium channel blockers and nitrates) and drugs that affect renal function (such as ACE inhibitors or the drugs ending in -pril). Beta blockers and drugs that relax and dilate arteries are also used to treat angina. Hope that this helps to explain things for you.

[RATP in reply to Steve_G]

Amazing! Thank you. I wish my cardiologist was as clear and concise!

[Harefieldfan]

Hi RATP. Mine was 85% blocked. They gave me a stent. Have they not offered you an angioplasty?

[RATP in reply to Harefieldfan]

they attempted it but abandoned it as it wasn’t possible to fit a stent. Not sure why not!

[Harefieldfan in reply to RATP]

Mine was clogged with calcium. First two attempts also abandoned. So they referred me to Harefield Hospital, where they had a specialist in rotablation, which means they use a tiny drill to get the calcium out. (It doesn't hurt.!) Can you request rotablation? The surgeon's name is Dr Tito Kabir.

[tunybgur]

Hi RATP,

I had a heart attack where my RCA was found to be blocked and a stent was duly fitted.

The angiogram also revealed the distal LAD was 90% blocked but there was nothing that could be done about it.....not sure why.

My BP is 125/70 and hasn't really changed much over the years.

That was 10 years ago, I'm still here going to the gym and playing golf three times a week.

Good luck.

[RATP in reply to tunybgur]

That’s very comforting. Thank you.

[Steve_G]

I’m afraid that my knowledge of the effects of exercise on blood pressure is pretty much non-existent. The control of blood pressure is complex involving peripheral barorecptors located in the major blood vessels (these monitor blood pressure), the brain and the kidneys. In non-pathological states, the goal is to maintain blood pressure at normal levels by changing 1) blood volume, 2) peripheral resistance (by relaxing or contracting the smooth muscle in blood vessels) and 3) cardiac output (the volume of blood pumped out each beat). Pathological states such as hypertension change everything, so as you say, post exercise hypotension has been seen in people with high blood pressure and as you say, this can last for a number of hours. I found a publication which is very technical, suggesting a role for the brain and baroreceptors but it looks like there may be acute/long term effects of exercise and the mechanism isn’t really understood (ncbi.nlm.nih.gov/pmc/articl....

Sorry I can’t answer your questions. If you have any concerns, you should talk to your GP.

[tunybgur]

Hi, yes I take a combination of meds for BP, I think this is fairly normal.

My combination is Ramipril (ACE inhibitor), Amlodipine (calcium channel blocker) and Bisoprolol (beta blocker). My resting BP is about 125/70 and my pulse is 46.

I found the beta blocker had the greatest immediate effect on BP and pulse rate dropping both significantly overnight, the ACE inhibitor doesn't seem to have a big effect but that may be because it's not supposed to be so effective in people over 50.

I also take a Statin for cholesterol and Flecainide for AF.

Hope this is helpful,

Good luck