Over Medicated - BP too low?

[mountainsoft]

After switching BP meds a few times over the last couple years, I've been on Amlodipine and Metoprolol the last six months or so. They brought my BP below 120/80 and I seemed to tolerate them better than previous meds.

A few months ago I switched to zero sugar soda's, and have been getting more exercise after getting an energy boost with vitamin B12 and D. I've lost about 10-15 pounds over the last few months as a side effect.

I feel pretty good overall, though my energy level seems to go from high to low quicker than it seems like it should. I will start a project and get tired fairly early even if it's not overly strenuous.

My heart rate averages in the low 50's on metoprolol, though the last few weeks it's been dropping down in the 40's a lot. No matter how hard I'm working, I haven't seen my heart rate get above 65 or so which may be partially why I tire so quickly.

I've also noticed my BP seems to be getting lower, especially the diastolic. My upper systolic has been around 105-115 lately, while my diastolic is in the low 60's. It has even dropped into the upper 50's a few times. That seems too low?

It may be coincidence, but it seems like my PAC irregular heartbeats have increased as my blood pressure has decreased. I have yet to find a dependable trigger for the PAC's, though they seem to happen most right after initially exerting energy (carrying suitcases up stairs for instance), but go away if I keep exercising.

Everything came back normal on my echocardiogram a few months ago, and my O2 levels were at 100% the last couple visits.

I'm glad my BP is down, but I'm curious if this is too much of a good thing?

I have a doctor appointment next week, but am curious if anyone else has encountered low BP like this?

 

[W2R]

Frank is on BP meds too, (I think maybe the same ones you are on?) and his diastolic is down in the lower 50's which scares me. I pushed him to specifically ask his doctor about it, and the doctor said it is not too low for him. Since his doctor is qualified both as an internist and a cardiologist, I figure he has to know what he is doing.

But still, that's just anecdotal. It seems to me that the best thing to do is to tell your doctor about your concerns at your visit next week and see what he thinks, given what he knows about your individual health situation.

Your BP may be higher at his office, due to "white coat syndrome" that many of us get which raises BP at the doctor's office. So, if you have a record of your daily BP measurements at home, take that with you.

 

[Aerides]

I'd start measuring twice daily (morn/eve) until your appointment, around the same time if you can. Track and bring that data to your Doc.

He might want to lower your dosage, especially since you've made other compensating lifestyle changes.

Your BP sounds great, but you wouldn't want to take a pill at the time you are very low. So make that part of your measurement schedule.

 

[xlf11]

I had high BP before and after a few years on water bill it was under control. One thing I noticed was during fall/winter season, it was the mostly higher due to season's change (probably because blood vessel contraction) while summer time was usually lower for the same reason. It is still similar trend now that I stopped medicine, just a slightly higher during the fall/winter transition, but close to normal during summer.

 

[Morgan22]

I took Metoprolol for a few months. (I have a high heart rate but blood pressure naturally on the lower side. normally about 100/70) The Metoprolol initially helped slow down my rate, but then I was near fainting to eventually fainting.

To be on the safe side, maybe call your doc before your appointment next week? Your doc may have you reduce your dose or switch you to another med.

 

[swakyaby]

Since you’re on a medication (metoprolol) that lowers both heart rate and blood pressure, I would start a record of your morning and evening BP and heart rate and show this to your doctor at your next appointment. Explain your recent weight loss and dietary change and that you are experiencing easy fatigue which is unusual for you and concerning to you.

 

[Scuba]

Showing your data to your doctor is a good idea. DH was put on two blood pressure meds after his quadruple bypass, even though he didn’t have high BP before. He was getting light-headed and dizzy a lot so his cardiologist almost immediately eliminated one of the two meds. He’s still on Metoprolol and his BP is often quite low - 90 something over 50 something. Seems too low to me but his cardiologist is ok with it, at least for now.

 

[MRG]

I had beta blocker induced bradycardia(RHR 33 in ER) and I could have written your post. I'd consider asking to lower your metoprolol, you'll feel better. Seriously consider contacting your doctor tomorrow AM.

 

[skyking1]

the doctor will make an adjustment for that, do ask as suggested above. When I am doing a whole bunch of cardio I can work myself too low on the BP and get Orthostatic hypotension, getting dizzy when standing up etc. I cut the BP meds in half for a while last time I got there, and eventually DC'd them.

 

[mountainsoft]

Thanks for the input, I appreciate it.

I take my BP a few times a week, sometimes twice a day depending on how I'm feeling. So I usually show up at the doctor with an in depth BP log, home ECG charts, and a to-do list of things I want to talk about. I also have the white coat syndrome when visiting the doctor, which they don't help by taking my reading as soon as I've walked up the stairs to the office.

The downward progression in readings has been slow, so I'm not too worried about waiting till next week's appointment. I just thought the 60 diastolic was the low danger zone, so it caught my attention to see mine get that low. I had been right around 135/85 the vast majority of my life before starting meds, but had a 170/95 reading at a dentist appointment a couple years ago that scared me into taking meds.

 

[razztazz]

Showing your data to your doctor is a good idea. DH was put on two blood pressure meds after his quadruple bypass, even though he didn’t have high BP before. He was getting light-headed and dizzy a lot so his cardiologist almost immediately eliminated one of the two meds. He’s still on Metoprolol and his BP is often quite low - 90 something over 50 something. Seems too low to me but his cardiologist is ok with it, at least for now.

I am on Metoprolol and Lisinopril for a heart attack w/ 3 stents and my BP is always in the 90 / 50 (sometimes 60) somethings. I get along well with it but the dose is lower than what a heart attack patient would normally get. My BP was always low however. 100/60 neighborhood and that goes way back to the 70's

 

[Dash man]

I take Metoprolol, amlodipine, valsartan and chlorthalidone to control my blood pressure. Now it’s typically around 108/64, and has dropped below that on occasion causes lightheadedness. Usually it’s short lived. For years I was on cozaar and amlodipine, but my BP suddenly spiked up to 196/110, so my nephrologist started trying new combinations of medications until it was under control after about six months of trials.
All I can recommend is to check your BP frequently even if things seem good for a long period of time.

 

[retire to nature]

metoprolol and other beta blocker decrease the heart rate. So it is required to check HR before taking the med. Lower than 60 hr before the med, it is supposed to hold the med. Your doctor should know about it and need to change the med if you have low HR issue. less than 60 HR can be normal for a few people like athletic, but if you see in 40's, it is alert to check with doctor.

 

[Bamaman]

My heart rate averages in the low 50's on metoprolol, though the last few weeks it's been dropping down in the 40's a lot. No matter how hard I'm working, I haven't seen my heart rate get above 65 or so which may be partially why I tire so quickly.

I've also noticed my BP seems to be getting lower, especially the diastolic. My upper systolic has been around 105-115 lately, while my diastolic is in the low 60's. It has even dropped into the upper 50's a few times. That seems too low?

I'm glad my BP is down, but I'm curious if this is too much of a good thing?

I have a doctor appointment next week, but am curious if anyone else has encountered low BP like this?

Anytime your heartbeat gets below 50, you should pay very close attention. And with low blood pressure you could be in serious danger. Have you by chance had any problems with AFIB?

I hope your physician is good at what he does. A cardiologist and some testing might be in order.

 

[Aerides]

I also have the white coat syndrome when visiting the doctor, which they don't help by taking my reading as soon as I've walked up the stairs to the office.

This is a good place to remember you are a customer as well as a patient, and can ask them to wait. Or, sit outside for 5 mins after those stairs before even going it, to get back to normal.

You're right it's usually a quick walk back to the office, then jump and perch on the table, get your arm right, often a bit flustered - the worst time to take it! After a high reading where a doctor insisted on diagnosing me (one reading, first visit, despite me always being 110/70 and telling him that...), and now I have them do all the other stuff first and take the BP in the chair, not up on their silly table where my legs don't reach the step.

And I never went back to that doctor again.

 

[wrigley]

My wife's normal BP is around 90/50. Sometimes it's even lower than that. No meds ever. She's does get some strange looks from med techs though. I'm just the opposite. If I can get to 130/90 (average) that's good for me and I'm on mediation (Lisinopril and Amlodipine). Last doctor's visit I was 126/82 and I was proud as peacock until the DR came in and told me the new diastolic number is now 70. I told her I couldn't get to 70 when I was in my 30's and in shape. What makes you think 30 years later I'm going to get to 70?

Mike

 

[pacergal]

I would imagine its the increased exercise and weight loss that is contributing to the lower BP. congratulations on the changes to your daily health habits!

The metoprolol is probably the culprit, now the you have lost weight.
Definitely take a record of daily at home BP checks, and make sure the medical assistant takes your BP correctly:

After 5 minutes rest, sitting quietly with feet flat on the ground, arm resting at heart height. Then take BP, using correct size BP cuff.

 

[RAE]

Metoprolol reduces your heart rate, and some people do feel fatigued or get tired easily when they are on it (common side effect). I'd say it's a pretty safe bet that the metaprolol is causing your problems. I'd talk to your doc and see if a lower dosage is needed.

Side note: I was on metoprolol for almost two years - not for high blood pressure, but to correct an irregular heartbeat (PVCs, or premature ventricular contractions). It definitely worked, but eventually I started getting dizzy spells, and couldn't figure out why. It turns out that dizziness is another fairly common side effect of metaprolol. And you can take it for quite a while and feel fine, and then at some point the side effects can kick in. I ended up stopping the metaprolol, and the dizziness went away immediately. No more PVCs, either, so no need to take it anymore.

 

[Time2]

I've been taking Edarbyclor for maybe for maybe 7 yrs. The first day I took it, I found walking up three steps caused my light headedness. I cut the dose in half and took half a pill for maybe 5 years, then it seemed my BP was increasing, so I took 1/2 a pill in the morning and 1/2 before bed. About 2 weeks ago I started a Carnivore diet, and I'm having bouts of light headedness and when I measure my BP I have had outliers of 88/52, 80/51, 90/56 and 92/56. When I'm not light headed I'm still below 120/80, Like 107/67 or 114/63. So I have dropped back to 1/2 pill. I have lost 10 lbs, but about half because summer came and did more biking and swimming. and the other half in the two weeks since I started the carnivore diet. I do see lots of online stories of people that had lower BP after starting a Carnivore Diet. I'll keep watch on my BP and check in with my doctor, but, I could not keep taking the whole pill and have the light headedness.



As my reference, I did Keto about two years ago and lost 23 lbs and my cholesterol numbers had a very dramatic improvement. As an example my Triglycerides dropped from 397 to 82 when tested after 3 months on Keto. If anyone is interested, I'll post the other numbers.

 

[mountainsoft]

talk to your doc and see if a lower dosage is needed.

I'm already on the lowest 25mg dose, so I would have to resort to cutting pills in half. That would be annoying to say the least. I tried that once and the pill shattered into dust.

I was on metoprolol for almost two years - not for high blood pressure, but to correct an irregular heartbeat (PVCs, or premature ventricular contractions). It definitely worked, but eventually I started getting dizzy spells, and couldn't figure out why. It turns out that dizziness is another fairly common side effect of metaprolol. And you can take it for quite a while and feel fine, and then at some point the side effects can kick in. I ended up stopping the metaprolol, and the dizziness went away immediately. No more PVCs, either, so no need to take it anymore.

The whole reason my doc put me on Metoprolol was because I started having PAC's after being on Losartan for six months. I never had a rhythm problem in my entire life, then suddenly started having lots of them. I stopped taking the Losartan and the PAC's decreased. Of course, BP went back up without the meds, so doc prescribed Metoprolol in an effort to improve BP and the PAC's. BP is definitely down, PAC's decreased a while but seem to be getting more frequent again. Still wonder if the meds are causing it.

 

[Lakedog]

Anyone ever try taking a zinc supplement to lower BP? I don't have high BP but after a few skin surgeries, my doc mentioned that some people seem to benefit from zinc (to speed healing of incisions). I started taking zinc and noticed a drop in BP as long as I was taking it. Some research online also indicated a possible correlation between zinc levels and BP. My average BP prior to the zinc was right around 120/80 but averages 105/75 while taking zinc. There were no other diet or supplement changes although I do take vitamin D. Not a huge drop in BP for me but mine was not high to begin with.