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High Blood Pressure

High blood pressure with slow pulse



When my grandmother is nervous, her blood pressure shoots up, as high as 180-200, while her pulse drops to 60-65. This happens regardless of whether she is taking medication, and what kind. She has tried lisinopril (ACE blocker), indap (diuretic), amlodipine (calcium-channel blocker) + olmesartan (angiotensin 2 receptor antagonist).

She is 73, with no other significant health problems. Her cardiogram indicates a mild atrophy of the left ventricle. That might well be caused by her high blood pressure problem.

As I understand it, a combination of low pulse and high blood pressure is very unusual. Does this symptom suggest a specific syndrome and treatment?

Thank you very much!


The combination of slowing of heart rate and rise in blood pressure is not that unusual.  As people get older, the regulation of blood pressure and heart rate with changes in position or in stress level loses precision.

Because of hardening of the arteries, blood pressure tends to go up more with increased stress.  As long as the average blood pressure throughout the day stays controlled (under 130/80 for most people), these changes are probably harmless.

A heart rate of 60 to 65 is normal.  In general, as long as your grandmother feels well with these changes in blood pressure and pulse, there is no need for concern.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati