Worried about increasing dosage

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I am on 2.5mg per day after a heart attack in March. My heart rate is slowed- resting used to be 70/80 but now 50/60 and my BP used to be 148/100 but now 110/65 consistently. Cardio nurse wants dosage increased as per NICE Guidelines to titrate upwards as long as tolerated. However I am worried about slower HR and lower BP. At night heart rate can be 39. What can I do?


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  • Posted

    Hi Lenny,

    My advice is go and get a second opinion. 

    Your bp readings seem fine I'm also on 2.5 mg ,I wish my readings were as low. 

    Do yourself a favour and speak to your GP or consultant before deciding wether to increase the dose.

    Good luck. 

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  • Posted

    lenny36...Heart rates at 50/60 is fine, as long as it doesn't get lower than that. Mine is usually 60bpm because of the beta blocker I'm taking. It can get down to 54 when I'm quiet & resting. Your bp is great..no worries ther.

    You mention the 'Cardio nurse"..NURSE is the word that bothers me. I don't know where you live, but is this nurse a Nurse Pracitioner? Here in Canada, Nurse Practitioners can prescribe medications, & make referrals to specialist. They of course do have limitations, & do not have the same scope as an M.D. I'd be concerned about a nurse adjusting heart medication, but that's just my opinion. She is not a specialist by any stretch.

    You didn't say what medications she is suggesting to increase the heart rate. If you're on a beta blocker, it would seem to be that perhaps a decrease in the medication would work. The higher the dosage, the lower the heartbeat. See what I mean?

    You need to ask questions...don't be shy about it.

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  • Posted

    Thanks Tino and Mike your advice is helpful. The medication that cardio nurse wanted to be increased is Ramipril. I will go back to my G.P. as I am not sure how I would manage if HR and BP reduced further. Appreciate your input.
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    • Posted

      lenny36..by all means get back to your GP. You said the medication the Nurse wanted to increase was Rampiril. In case you're not aware, Rampiril is a BLOOD PRESSURE MEDICATION!!. If your b/p levels are usually at what you've written, I see no reason to increase the bp medication which in all liklihood would reduce the bp even further. Furthermore, it disturbs me that a Nurse..of all medical professionals...is the one wanting to increase medication. Here in Canada, unless she were a Nurse Practitioner, & you didn't have a GP, she wouldn't have the authority to be increasing medications. No nurse does, unless again she's a Nurse Practitioner. Usually a Nurse Practitioner working in a GP's office will see patients when the patient doesn't want to bother the doctor. Some see her on a regular basis, but when she's got questions she's not sure of., she consults the doctor. You on the other hand, have a GP. He/she is the one who's qualified here. Actually, I'm a little angry with the nurse you've mentioned. Don't let this upset you..but by all means get back to the GP. I don't profess to be a doctor, certainly I am not, but I truly don't see the sense in increasing the Rampiril when your bp levels are consistently as they are.

      Please let us know how you get on with this.

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