Managing Arrhythmia and High Blood Pressure: When to Seek Further Testing

Arrhythmia Blood Pressure

Hello Doctor: I have issues with arrhythmia and elevated blood pressure.
I previously took antihypertensive medication for a month but felt uncomfortable, so my doctor advised me to improve my diet and habits regarding alcohol and smoking.
After stopping the medication and monitoring my blood pressure at home, it has remained below 130 for six months.
Six months ago, I also went to a military hospital for a 24-hour Holter monitor, an exercise stress test, and blood tests.
The doctor said the results showed only mild arrhythmia, and there were no significant abnormalities in the myocardium.
He mentioned that it could likely be due to long-term alcohol consumption, smoking, and poor sleep, and it might also be related to autonomic nervous system issues.
Recently, with the significant weather changes in winter, my blood pressure has risen to between 135 and 150, and I am experiencing discomfort in my heart along with irregular heartbeats.
Should I undergo another series of electrocardiogram tests, or should I seek treatment related to the autonomic nervous system? Thank you.

A Guo, 40~49 year old female. Ask Date: 2017/01/29

Dr. He Dongjin reply Cardiology

Hello, recently the weather has been fluctuating greatly in winter, and having blood pressure ranging from 135 to 150 is considered normal.
It is recommended to visit a cardiology clinic for evaluation.
Taking some medication for adjustment should help.
Changhua Hospital cares about your well-being.

Reply Date: 2017/01/29

More Info

Managing arrhythmia and high blood pressure can be quite challenging, especially when lifestyle factors such as diet, alcohol consumption, and smoking come into play. Based on your history of mild arrhythmia and elevated blood pressure, it’s essential to take a comprehensive approach to your health.

First, it’s crucial to understand that both arrhythmia and hypertension can be influenced by various factors, including lifestyle choices, stress, and underlying health conditions. Your previous experiences with blood pressure medications and the discomfort you felt while on them suggest that finding the right treatment plan is essential. It’s good to hear that you have managed to keep your blood pressure under control at home, averaging below 130 mmHg for six months. However, the recent fluctuations you mentioned, with readings between 135 and 150 mmHg, indicate that further evaluation may be necessary.

Given your symptoms of discomfort in the heart and irregular heartbeats, it would be prudent to seek further testing. While your previous tests, including a 24-hour Holter monitor and exercise stress test, showed only mild arrhythmia, the changes in your condition warrant a re-evaluation. The fact that you are experiencing discomfort and your blood pressure has risen again suggests that your current management plan may need adjustment.

Here are a few steps you might consider:
1. Consult Your Cardiologist: Given your history and current symptoms, it would be wise to schedule an appointment with your cardiologist. They can assess your condition more thoroughly and determine if additional tests, such as another Holter monitor or an echocardiogram, are necessary.

2. Lifestyle Modifications: While you have already been advised to improve your diet and reduce alcohol and tobacco use, it’s important to continue focusing on these areas. A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can significantly impact your blood pressure and overall heart health. Regular physical activity, even moderate exercise, can also help manage both blood pressure and arrhythmia.

3. Monitor Your Symptoms: Keep a detailed log of your blood pressure readings, heart rate, and any symptoms you experience, such as palpitations, dizziness, or chest discomfort. This information can be invaluable for your healthcare provider in determining the best course of action.

4. Consider Stress Management: Since you mentioned that your symptoms may be exacerbated by stress and changes in weather, exploring stress management techniques such as mindfulness, yoga, or breathing exercises could be beneficial. These practices can help regulate your autonomic nervous system, which may alleviate some of your symptoms.

5. Follow-Up Testing: If your cardiologist deems it necessary, they may recommend further testing to evaluate your heart's function and rhythm more closely. This could include repeat ECGs, echocardiograms, or even an electrophysiological study if they suspect a more significant arrhythmia.

In summary, while your previous tests showed only mild issues, the recent changes in your condition suggest that further evaluation is warranted. It’s essential to work closely with your healthcare provider to monitor your symptoms and adjust your management plan as needed. By addressing both lifestyle factors and potential underlying health issues, you can better manage your arrhythmia and high blood pressure, leading to improved overall health and well-being.

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