inappropriate sinus tachycardia and diastolic hypertension

Posted , 6 users are following.

Hi there, I would love to hear from folks with inappropriate sinus tachycardia who have experienced elevated BP as a result of the tachycardia.

I have had a resting heart rate of 100-110 for a long time, but it never caused me any issues. BP was always low normal-120/70, no shortness of breath, no exercise intolerance. After heavy periods, I ended up with anemia which caused shortness of breath that still persists (nearly 5 months later). My BP suddenly went up to 108 diastolic (systolic didn't go above 135 or so), was accompanied with flushed skin, shortness of breath, severe headache and chest discomfort. I was initially put on HCTZ, which didn't help. I saw a cardiologist who suspects my BP spiked from the tachycardia (weird as that hasn't happened in all these years..but very possible). He put me on 2.5 mg of Bisoprolol twice a day, starting with once a day and going up if HR is still above 90. The 2.5 mg brought my heart rate down to 70 and my diastolic down between 77-84 (which is still a bit higher than it used to be before the spike). I am not taking the 5 mg as it lowered my heart rate to 50, and I am not very comfortable with that plus from what I am reading it's a hard medicine to wean off (something I'd like to do eventually, under medical supervision of course) so if I am doing well on a lower dose, I'd keep it that way,

I would love to hear from anyone who can relate to this or has any thoughts/experiences to share.

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  • Posted

    I have also had periods of markedly elevated diastolic blood pressures (>100), but usually not accompanied by tachycardia, although sometimes accompanied by benign premature ventricular contractions (palpitations). You might check out POTS, which is postural. I have had these symptoms over a year, but so far they seem harmless other than causing anxiety.

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    • Posted

      I have had PVCs for a long time, but no more than 20-30 or so in a day. were you able to discover what caused your diastolic BP to rise?

      I have been looking into POTS, possibly something like hyperadrenergic POTS which causes high rather than low BP with standing up. My heart rate get high when I stand up, but it doesn't go higher than 90 now that I am on bisoprolol.

      What was your BP like before the diastolic reached 100s? Was your bp spike accompanied with any other symptoms?

      Mine caused flushing all over my face, even my palms were very red and warm to the touch. I had a severe headache and had chest discomfort too, even though the systolic was only about 130ish. The doctor thought it may have resulted from anxiety. Anxiety has never caused high BP for me before, and I wasn't anxious before any of this happened. When I would get very anxious in the past, if something super anxiety inducing happened, I would get very cold hands, dizziness and such. Never headaches, hot flushed skin, chest heaviness and so on. I have the feeling this isn't essential hypertension or anxiety.

      A few days before this happened, my Bp was 115/60. The day I had a MIBI scan to see if my shortness of breath had cardiac causes, my BP was 120/67 and during the test (which made me anxious because I had a very bad reaction to the Persantine - nausea, headache, chest pain, shortness of breath) the highest it reached was 150/80. My heart rate did reach 160. Even so that diastolic didn't hit 100s. The body is just so weird and confusing sometimes.

      Thanks for replying and sharing your experience. It helps to know I am not alone.

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    • Posted

      I have been having "spikes" for a little over a year, and unfortunately I do not have a good explanation. I also had facial flushing and cold hands during the early more severe spikes. My blood pressure before the spikes is generally around 125/85 (untreated by bp medicine), but when it spikes it usually reaches up to 150/100. I used to also experience thirst when having the spikes. I have had spikes as high as ~170/~110.

      The best "guesses" for me after evaluation are that I am experiencing some sort of vasospasm caused by a dysfunction in my circulatory system. The spikes began occuring about one year after beginning treatment with Losarten 50 mg, and I was taken off all bp medicine. I tried 5 different bp medications and my body reacted to all of them.

      Anxiety does make the spikes worse, so I suggest Cognative Behavioral Therapy and meditation. By using CBT techniques I think the magnitude of the spike is a little lower, and certainly more tolerable.

      Also, when I "spike", I have learned to relax as much as possible, hydrate, find some time by myself if possible, and the spikes invariably pass. I have yet to determine a trigger, as they seem to occur randomly.

      Finally, I did find cutting gluten out of my diet seemed to help, as it can be inflammatory in some people. I am not gluten intolerant (tested), but I did adjust my diet to eliminate gluten and reduce sodium, which seems to have helped. As others have posted foods rich in magnesium and other micronutrients also seem to help reduce the overall frequency.

      You have my sympathy, and I am sure you will get through this. I am happy to share more as well if any of this helps you, and I am certain what you discover will help me.

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    • Posted

      Hi there, thanks for sharing and for the reassurance. Could I ask what the losarten was initially prescribed for? Was it for your BP or another condition? I ask as 125/85 before BP meds doesn't sound bad at all. I am sorry the BP meds didn't sit well with you. Many of them cause side effects. I am doing okay on the bisoprolol so far. Keeping fingers crossed it stays that way.

      Could I ask which tests/scans helped them consider a vasospasm in the circulatory system?

      I have been low carb and mostly gluten free for 6 months now. I read on the keto forum that a lot of people had their BP go up on keto. The running theory is that it's from electrolyte imbalances. Keto is the one big change I made in the past couple of months, and I am heavily considering if it was a factor. My sodium and potassium were normal, but the magnesium wasn't tested. Magnesium regulates heart rate and BP, so if I am deficient in it, that may explain the diastolic hypertension. My systolic doesn't go over 135 in these spikes. Even on the bisoprolol, I am getting a diastolic of 85 in most of the readings. It's much better than the 100 and high 90s. But I think it's curious that the diastolic is still a bit elevated. I don't feel any anxiety with the current BP, but when it was hitting 100s and causing headaches, flushing etc., that was anxiety inducing. The BP did lower eventually when that happened, as with yourself. But doctors think anxiety was the cause, which I don't think is right. I lost weight, have great cholesterol, great BG and if anything was less stressed, and still the diastolic went up and caused a ton of symptoms.

      I would suggest getting your TSH, free t3 and free t4 tested to see if your thyroid might be involved.

      Pheochromocytomas are quite rare, but they can also cause BP spikes (often in the 200s though for systolic but that's not necessary) with flushing/paleness, severe headaches, chest pain, anxiety. That sounds like it could be anything, but sadly most pheos are diagnosed via autopsies so people can have them for years and live with hypertension and never find out. If you're otherwise healthy and have sustained d iastolic hypertension and/or high spikes that are symptomatic, it might be worth discussing with your doctor. Also see if your white and red blood cells are normal. If they're both elevated, it may be a good idea to see an endo.

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    • Posted

      Thanks for sharing the excellent information. To answer your questions I was put on Losarten as I was hypertensive, but only mildly so (>135/>90), Losarten brought my bp down to <120/<80, but I was not monitoring it. When I finally did (after a year) it was down to ~100/~60 much of the time (therefore I was weaned off of it).

      I have had extensive testing, including an echo, renal ultrasound, stress test and my heart is fine. Also went through testing for abnormal catecholmines, but those were normal. The only abnormal tests have been for high red blood cell count. I have also had my thyroid tested multiple times.

      After a year of sporadic testing though I have kind of given up. I don't take any medication, but I do take 100 mg of magnesium daily, and that has really cut down the PVCs.

      I have wondered if there is a connection to auto-immune, as it seems as though there may be a link between high diastolic readings caused by inflammation. That is why I quit the gluten, as I think inflammation seems to make the spikes more severe.

      Finally, it was suggested to me that I consider reducing exposure potential to toxins, as those can cause non-specific symptoms (including labile hypertension). You may consider this as well.

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  • Posted

    I have some nonspecific arrhythmias and some may cause elevated BP - or be caused by elevated BP. Can go either way, hard to know what's what.

    I too have found the standard dose of beta blocker too much, but the lower dose can be very helpful.

    As long as you stay on the lower dose, weaning off should not be terribly difficult, if you're lucky enough that that works out for you.

    Hey, you want to try a home remedy here, looks pretty low risk? Arugula! That's the little salad leaf, in case you don't know. Should be available at any market. It's high in nitric oxide, which is an artery expander. Beets are also in that category, btw. Anyway, just have a little arugula salad at least once a day for a couple of weeks, and see if symptoms seem to improve. I usually don't recommend any dietary approaches that take more than 24 hours to evaluate, but this one seems to take a while. Too much nitric oxide, like having arugula and beets, may make symptoms worse! This is all pretty anecdotal, I know, but hey, it helps to pass the time, and it could work, and it's a healthy diet in any case.

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    • Posted

      Hi thanks for sharing! I am going to try the arugula. I have also heard chia seeds lower blood pressure. My inappropriate sinus tachycardia predates the BP by at least a decade. I didn't know that arrythmias could cause higher BP, but that would make sense.

      On the bisoprolol, my BP stays between 105/75 and 110/85. Most often I see the diastolic as 85. Way better than hitting 90s and 100s, but I'd like it to be 80 or lower ideally. I walked quite a bit today, had some shortness of breath, even though my chest felt very was relaxing that my heart wasn't racing. Still had the shortness of breath unfortunately. I tested my BP five minutes after I got home, just to see how it was impacted by activity. It was 110/85, which is exactly what I get if I have been sitting for half an hour. I am going to take my monitor to the doctor's again and see how it matches.

      I can only have a small amount of beets, as I am on keto for managing t2d with which I was diagnosed very recently. Luckily, my A1C at diagnosis was 6.5, so lowering my carbs was enough to drop it to 4.8. And I am maintaining very well.

      I am not sure if you're familiar with keto, but I read on keto forums that many people seemed to develop high BP on the diet! Turns out it's from electrolyte imbalances. Because my cholesterol is perfect. Blood sugar is excellent. Fasting is always in the non diabetic range, great A1Cs. So it's not the cholesterol or BG. I did start supplementing magnesium, in case all the peeing on keto had caused a deficiency.

      p.s. does this board not have a post edit function?

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  • Posted

    I believe that juicing dark green vegetables will address many of these symptoms. They will provide micro nutrients and minerals that we all need on a daily basis. Most of us are deficient and symptoms seem to appear as a person gets older. I also recommend watching Dr. Bergs videos on youtube. Information is life saving.

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  • Posted

    Hi there,

    I do not have IST, but I do have AT ( atrial tachycardia)

    When ever I have an episode, I blood pressure goes way up. I have taken my bp just prior and it was fine. Then my episode started and it is like a switch, and my bpm is 160. I take my bp, and it can be 160/100 Once the episode stops ( again like a switch), I then check my bp 20 minutes later, and it is back down

    aAlso I wanted to mention that I used to take bisoprolol for my tachycardia. I was told to just stop it 4 days prior to an attempted ablation. I asked if just stopping the biso was okay, and was told it was just fine. Well, it was not just fine. I had huge withdrawals with anxiety and legs that jerked and jittered and had trouble walking. This opened a huge can of worms for me. I did not make the connection to the biso being stopped, and assumed it was anxiety. I was then put on trazodone and clonezepam which was the worst thing I had ever done. Withdrawling from those was an nightmare and still is one

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    • Posted

      Hi there,

      Thanks for sharing your experience. It sounds very stressful to deal with AT and High BP.

      I have been reading a lot about beta blocker withdrawal, and I am going to be very careful not to let doctors take me off Bisoprolol too quickly. I am sorry withdrawing from those other meds was a nightmare.

      This whole heart rate thing is ridiculously stressful. I honestly wish I could go back to the time when I had tachycardia but no other symptoms.

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