When Is My Resting Blood Pressure Too Low?

[gjensen]

Forgive the new guy. I experience something new everyday.

Started a beta blocker recently. During the day my blood pressure is manageable. At rest it drops lower than I ever have. I am at rest, but I was not feeling well. I checked it and it was 107/41. I checked it a few minutes later and it was 87/49.

Is something I should be concerned about, or is this tolerable?

I would hate to come off of the beta blocker. Without it my heart rate gets past past 200 upon standing. A couple of times near 250 out of nowhere, while at rest.

I am only taking 2mg (approximately) of bystolic per day. I am cutting 5mg tablets.

[MomtoGiuliana]

Welcome to DINET.

I would check with my doctor. I know my doctor does not like my bp that low, however one reading may not give a full picture either.

[looneymom]

Be patient with new medications. Your body may be trying to adjust to them. I would call the doctor and tell him what's going on. It maybe that your body needs a week to adjust if you are just starting this medication.

Rachel

[Hope]

I echo to check with you doctor. I take a beta blocker to keep the heart rate down and Midodrine to keep my blood pressure up.

[KareBear]

My doctor told me it would take me 4-6 weeks possibly to not feel horrible on my new beta blocker and to push through and he felt confident I would adjust to it. It was a terrible 2 months almost for me but he was right I did adjust to it. Like the others said, I would keep your doc in the loop about it but it is possible you need more time to adjust.

[yogini]

It is definitely personal, so your dr will know best. If you are not feeling well, it could be your BP, your POTS or the fact that you are getting adjusted to bystolic. From what I understand, though, bystolic is one of those betas that least lowers your BP.

If your dr decides your beta blocker is lowering your BP too much, you may be able to stay on it with another treatment BP.... there are lots of options to boost your BP...like compression hose or midodrine.

[Chaos]

Like Hope, I take a beta blocker to keep my HR down and midodrine to keep the BP up. I have been diagnosed with both POTS and NMH. The local docs always look at my med list and see those two and scratch their heads over it until they understand my situation a little better.

When I switched from Propanalol to Nadalol I was having issues with my BP going too low for awhile. Had to back off the low starting dose to an even lower starting dose and slowly titrate up. As others have said, probably best to check with your doctor, especially if you see this trend continuing.

[gjensen]

Thank you for the replies.

Something I need to fix, is finding a local doctor to work with. Though I am going to Duke University for work ups, I do not have a "treatment plan". I have been grinning and bearing it.

The Beta Blocker was prescribed after an ER visit, where my heart rate was near 250. The Beta Blocker was something to keep me happy, so to speak. I questioned the local cardiologist (who referred me to Duke), about my wildly fluctuating BP and HR, and I was told that that did not now what to do for me. My GP (maybe getting ready to used to be GP), explained that he did not know what to do, but he would do what I asked him to do.

Duke has not even considered any kind of treatment, yet. Maybe they think I am getting help at home?

I am like everyone here, looking to gain some sense of normalcy. I do not know what my next step should be.

[Chaos]

Ah yes, I see you are getting to enjoy the "do it yourself" brand of medicine that many of us have gotten to know and "love" over the years.

Do you have plans to return to Duke for further follow up? Or are they willing to work in conjunction with your local physician? Some facilities tend toward just doing evaluations and aren't particularly big on follow-up or treatment. I'm not familiar with Duke so you would need to check with them I think to see how they operate.

I think some people have found that it works for them to have a local doctor who is willing to learn and is willing to listen to them. Personally I don't expect my docs to know everything, but I would at least like them to be open to listening and respectful of the research I've done and the info I've found (from peer reviewed medical journals) and brought to them to help them help me.

Since I haven't personally had much luck (yet) finding a local physician who is willing to work this way, I travel out of state on a fairly regular basis to one of the specialty centers to see a doc who knows this field and who works with me.

I don't know that anyone can tell you what to do. Some things to consider would be: 1. see if Duke does follow up and treatment and see if that's a feasible option for you. 2. think about your local doc and if he is someone you think will be willing to learn along with you. If Duke will do some of the treatment plan for you , then he can learn as you go along. 3. Look at the DINET site and see if there are other docs in the area that are knowledgeable about POTS. A lot of times you need to see a specialist like an EP cardiologist or a neurologist with some background in it. 4. You might be able to call some local docs and ask them if they treat the condition. Or, ask around for internal medicine docs who might have a reputation for being good at treating people with more complicated diseases. They might at least be more willing to learn about your condition and therefore help you.

Good luck!

[gjensen]

Duke is on going, and their focus seams to be the "whys" and "hows". I am starting to wonder if any why or how will be found. I am impressed by the professionalism there.

I would not go back to the local Neurologist if you paid me to.

The GP does what I ask him to. That is good, and that is bad. This is new to me.

The local Cardiologist . . . maybe I need to discuss this with him further. He recognized what was happening to me as neurological.

I am considering starting off fresh with a new GP.

I live outside of a small town, and as I am, I cannot drive. I will have to work with what I have here. When I can get back to driving, I will have more options.

I recognize the importance of a sub specialist in these disorders. I also appreciate the access to the experience found here.

[Chaos]

A GP who will do what you ask can be quite helpful. Beats the heck out of docs like the endo I saw today who just rolls his eyes when I say something.

How are you doing today? You might want to keep a record for a week or so and see if you are still having the big shifts in BP over time. I know my POTS neuro insists on making any med changes slowly and one at a time. He also says you need to stick with things for awhile as the ANS takes a long time to sort things out once a change is made.

Best wishes!

[gjensen]

I do not know about my BP. It is so up and down. The only thing about it that is reliable is that it is certain to get too high when I am standing. With out without this beta blocker. Otherwise it all over the place.

The BB has (or I am giving it the credit) is keeping my HR spikes from getting way out of line. I can tolerate standing for longer periods of time.

Last night, on the way home from NC, bumpy sections of the road were giving me grief. My blood pressure would jump to 160/120 and a HR of 150, then drop, then rise. All depending on the highway, and I was laid back the entire time. I made the mistake of taking a vehicle with stiff suspension that we will not take any distance again. That was a long 3 1/2 hours.