Managing Low Blood Pressure and High Heart Rate: Expert Insights

Low blood pressure, rapid heartbeat, and elevated blood lipids?

Hello Dr.
Tsai, I have purchased a blood pressure monitor and an Apple Watch to track my heart rate throughout the day.
The values are as follows: Blood pressure: systolic around the 80s, diastolic around the 50s; heart rate: resting around 110 during the day / sleep heart rate originally in the 60s, but recently measured in the 70s.
In recent years, I have undergone an electrocardiogram and echocardiogram, with reports indicating mild mitral/tricuspid valve prolapse and regurgitation, complete right bundle branch block, and prolonged QT interval.
My blood test showed triglycerides at 133.
I have been taking medication for autonomic nervous system dysregulation, "Xinjie" and "Yangkang," for over four months.
My questions are as follows:
1.
With my long-term low blood pressure and fast heart rate, am I at risk for heart failure? How can I improve this?
2.
Do I need treatment? A doctor recently prescribed me "Xinbaole," but I found out it is a medication for high blood pressure.
Can I take it with my low blood pressure?
3.
Given my condition, I am hesitant to receive the COVID-19 vaccine, fearing that the AZ vaccine might raise my triglycerides and lead to thrombosis, along with my low platelet count (my platelet count is only 148, below the lower limit).
I am also concerned that Moderna/BNT might cause even faster heart rates or other heart issues.
Do you have any good advice? I apologize for the many questions, and thank you for your patience in answering them.

Liu Xiaojie, 30~39 year old female. Ask Date: 2021/09/03

Dr. Cai Guiqin reply Cardiology

It is recommended that you discuss the above situation with your attending physician to determine if further examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2021/09/03

More Info

Managing low blood pressure and high heart rate can be a complex issue, especially when considering your specific health conditions and medications. Based on the information you've provided, let's address your concerns systematically.

1. Long-term Low Blood Pressure and Fast Heart Rate
Low blood pressure (hypotension) combined with a high heart rate (tachycardia) can indeed raise concerns about heart health. In your case, a systolic blood pressure in the 80s and diastolic in the 50s is considered low, and a resting heart rate around 110 bpm is elevated. This combination can lead to inadequate blood flow to vital organs, potentially resulting in symptoms like dizziness, fatigue, or fainting.

Heart Failure Risk: While low blood pressure and high heart rate alone do not directly cause heart failure, they can be indicative of underlying issues, such as autonomic dysfunction or heart valve problems (like your mitral and tricuspid valve prolapse). Over time, if the heart is consistently under stress due to inadequate perfusion or if it has to work harder to maintain blood flow, it could lead to heart failure.

Improvement Strategies:
- Hydration: Increasing fluid intake can help raise blood volume and improve blood pressure.

- Diet: A diet rich in salt (if not contraindicated) can help retain fluid and increase blood pressure.

- Compression Garments: Wearing compression stockings can help improve venous return and blood pressure.

- Medication Review: Discuss with your doctor the possibility of adjusting your current medications, as some may contribute to low blood pressure.

2. Need for Treatment
Regarding the medication "心保樂錠" (likely a beta-blocker), it is crucial to clarify its purpose. Beta-blockers are typically used to manage high blood pressure and heart rate, but they can also be prescribed for anxiety or certain heart conditions. If you have low blood pressure, your doctor should carefully consider the risks versus benefits of prescribing a medication that could lower your blood pressure further.

Consultation: It’s essential to have an open dialogue with your healthcare provider about your concerns regarding this medication. They may need to monitor your blood pressure closely or consider alternative treatments that are more appropriate for your condition.

3. Vaccination Concerns
Your apprehension about receiving the COVID-19 vaccine is understandable, especially given your history of low blood pressure and heart rate issues. However, the benefits of vaccination generally outweigh the risks, even for individuals with underlying health conditions.
Vaccine Types:
- AstraZeneca: There have been concerns about blood clotting with this vaccine, particularly in individuals with certain risk factors. However, the overall incidence is low.

- mRNA Vaccines (Moderna/BNT): These vaccines have not shown a direct link to worsening heart conditions in the general population. In fact, they are recommended for individuals with underlying health issues.

Consult Your Doctor: Before proceeding with vaccination, discuss your specific health concerns with your healthcare provider. They can help assess your individual risk factors and provide tailored advice.

Conclusion
In summary, managing low blood pressure and high heart rate requires a comprehensive approach that includes lifestyle modifications, careful medication management, and regular monitoring. It is crucial to maintain open communication with your healthcare providers to ensure that your treatment plan is appropriate for your unique health situation. If you experience any new or worsening symptoms, seek medical attention promptly. Your health and safety should always be the priority.

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