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Thursday, April 24, 2014
High Blood Pressure
High BP with low pulse rate
My father-in-law, aged 72, is now in hospital with high bp and low pulse (ie, 190/110, pulse 45). Symptoms were extreme fatigue and dizziness. History is artificial aortic valve (pig tissue) in `01 with at least one stent put in place; diabetic; currently undergoing radiation for prostate cancer that has spread to some bones, namely left shoulder. Our question is, how can his BP be so high, yet his pulse so low?? The only treatment I know the hospital is providing is an oxygen tube to his nose, which seems to be helping.
It is difficult to give specific answers in a case without knowing all the details. Your father-in-law's low pulse rate may be due to medications (esp. beta blockers or certain calcium channel blockers), or to the presence of heart disease. He had an aortic valve replacement and has coronary artery disease. It is possible that he has a poorly functioning sinus node (the "clock" that sets the heart rate) and may need a pacemaker.
His high blood pressure should be treated. The type of medications that would be best will depend on the other treatments that he receives.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati