Hello, another question regarding high blood pressure

succes for everybody that reads this, look after yourself, there is only one person that can look after you and that is you!!

Hi Eileen,  I agree that taking BP med. is important in Ida's case.  However,  I just recently developed heart flutter which can turn into atrial fib, just had an ablation and they want to put in a watchman device.  All new to me!  Although I have always had an irregular pulse, I never had that dx. (recently had episodes of A-fib, flutter).  What surprises me is that you said PMR causes A fib.  None of my doctors ever told me that, I have a heart specialist and an electrophysiologist.  Are the doctors not aware of the connection?  Wow!     And next month I'm going for a cochlea implant.

I've had PMR for2 1/2 years now down to 2.5 mg. pred daily, feel good "in that dept."     t

My cardiologist is confident that the cause of the a-fib is the autoimmune process which underlies PMR having damaged the electrical cells in the heart. The occasional sensations had started much about the same time as the very first signs of PMR and I had repeatedly asked the GP who couldn't find anything (Nothing new there then!). 

They don't like to use abalation here except as a last resort - they don't work long term he says - and I have been well managed until recently. I had flu and a flare and the a-fib has been a pest for some weeks but raising the pred dose has made a real difference in the short term as we are on holiday but I shall be discussing this with the rheumy come May after a bit of experiementation with dose. 

They DO know that there is an increased incidence of arrythmias in RA - and the autoimmune part is much the same in various a/i disorders. I'd asked about it a few years ago and got the rather silly response that afib is more common in the age group anyway. That wasn't what I asked - is it more common in PMR patients than non-PMR patients? And I'll lays odds it is.

Great about your reduction and how you feel though!!!

Hi Eileen:  I only started the 2.5 dose a couple days ago.  I had been taking 3 for a month or so.  I had stayed on 5 for a longer period of time, so hoping the 2.5 is adequate.    Do you take a blood thinner for your A-fib?  My doctors so far have said the low dose (81mg) was OK for me.  I already bruise and bleed very easily from the larger doses of pred. I took when lst dx. with PMR.  One of the Watchman persons has told me I need to be on blood thinners espec. planning on the Watchman device. I refuse, I don't need any more complications  The ASA should be adequate.  However I have been more concerned since my sister had a stroke in Dec., went to rehab and died 3 wks later (Jan. 1).    I'm now being worked up for a cochlear implant, on April 13, and have to stop several meds, including Aspirin, fish oil, 2 wks prior ot surgery.   For a healthy person, I now feel I'm becoming a chronic medical case.  Ho hum!  In reality, I: should be thankful since so many of you have so man other medical issues.

Eileen: Another note while we're on the subject;  MD prescribed atenolol (tenorman) for my a-flutter, a beta blocker, dc'd the losartin, kept the amlodapine 2.5 (Norvasc), and added the ASA 81mg.  However, although the atenolol worked very well to greatly slow my heart, obvious side effects are depression, plus NO energy, an effort to get moving.  I cut the 50mg. BID to 25mg. BiD, it's doing well, still have those side effects, but less so.  Thanx for your knowledge, and I do realize you have so much to cope with.    Elinor

Yes, originally it was sintrom, a relative of warfarin and I wasn't allowed out of hospital until that was got right - they are very tough on that here. I was fine on that for a couple of years and then suddenly my INR went haywire and we couldn't sort it out even with almost daily INR checks, it would look fine and suddenly shoot up from 2.1 to 3.7!! Now I am on Pradaxa, one of the new generation ones.

Here they regard the blood thinners as the most important thing - especially with paroxysmal a/f as the episodes will stir up the sludge at the bottom of the ventricles - sending tiny clots off into the circulation. Which greatly increases the risk of stroke, heart attack and PE. The blood thinners reduce that risk tremendously and for many patients that may be all they need - my husband also has a/f but he doesn't notice it and carries on regardless. a/f is felt to be a primary cause of stroke.

I'm on 2.5mg bisoprolol and 25mg losartan (1/2 a tablet) which are both tiny doses - but combining them achieves a good result for the cardiovascular stuff without the very common no energy problems. I was put on an ACE inhibitor first - until I developed a beautiful allergic reaction in the form of a VERY itchy rash! that started to spread from my neck down my arms and trunk! So then we went to cardio guy's second choice and with a bit of tinkering reducing the losartan even further it's all been fine. Long may it stay so!!!!

I recently got back to 7mg pred - after a flare-plus caused by flu I think. I felt as if I was wading through treacle and the a/f was going mad - so I tried upping the pred to 10mg and magic - all gone! I'm back down to 8mg today - but this is going to be very interesting. Is the autoimmune bit active, causing some vasculitis and exaccerbating the a/f???? What are the chances of getting the cardiologist and rheumatologist to talk to each other? 

Elijo, aspirin is not adequate For atrial fibrillation because it does not act on all the clotting factors. My mom's neighbor said the same thing-she refused blood thinners saying her aspirin was enough. She had a fatal stroke in short order.

The blood  turbulence in the atrium from atrial fibrillation promotes fatal blood clots which cause strokes.

They should be writing you up in the literature.  What a complicated case you've become over the years!  Glad you are feeling better these days.

Not much chance of getting the MD's to talk together.  I actually do oonot have a rheumy, my internist did the dx and now over 2 yrs. later I do my own thing with the PMR doses, he trusts me.  He does get the lab work, wh;;ich is usually in the normal range, never was  real high even in the beginning when I was so crippled.      I actually feel that medical care is so fragmented, doctors seemed rushed and don't seem to get their heads together, as far as I can see.

Re: your comment on seeing a hematologist,  I started PMR with a large dose of prednisone, gradually decreasing, now 2.5, but that did a lot of "damage" to m skin and the healing of cuts process.