Managing Palpitations and Blood Pressure: Medication Concerns Explained

Medication issues related to palpitations?

Hello Doctor, I have hyperthyroidism and have been taking one dose of anti-thyroid medication and one dose of a heart rhythm medication daily for the past three months.
Sometimes I feel a bit fatigued.
When I measure my blood pressure at home (using an Omron blood pressure monitor), the average systolic pressure is between 90 and 100, and the diastolic pressure is between 65 and 75.
However, at the hospital, my blood pressure measured an average of 115/80.
I have also had my home blood pressure monitor calibrated, and it is functioning properly, so I am unsure if my blood pressure is genuinely low.

Does the heart rhythm medication also lower blood pressure? I am hesitant to stop taking it.
Currently, my pulse rate remains between 70 and 90, but I occasionally experience palpitations.
When I measure my heart rate, it is only between 95 and 100, which is not very fast, yet I still feel the palpitations.
This makes me reluctant to stop the heart rhythm medication, but I am concerned that taking it daily might lower my blood pressure.
I fear that if I don’t take it, I will experience palpitations, and if I do take it, my blood pressure might drop too low.
Should I stop the heart rhythm medication, or can I continue taking it? Thank you, Doctor.

A-Yao, 30~39 year old female. Ask Date: 2024/07/23

Dr. He Dongjin reply Cardiology

Hello, most people do not experience a decrease in blood pressure when taking heart rhythm medications, but individual responses can vary.
It's difficult to say if your fatigue is due to low blood pressure; it's important to first understand what your blood pressure is when you feel well and when you feel fatigued.
You might consider trying to stop the medication to observe your body's reaction.
This way, you can determine whether you feel more comfortable or uncomfortable, as well as monitor changes in blood pressure, palpitations, and fatigue.
Only then can you assess whether taking the medication is more beneficial or not.
Take care.
Changhua Hospital is concerned about your well-being.

Reply Date: 2024/07/23

More Info

Managing palpitations and blood pressure can be a complex issue, especially for individuals with underlying conditions such as hyperthyroidism (甲亢). Your concerns about the medications you are taking, particularly the heart rhythm medication (心律錠), and their effects on your blood pressure and overall well-being are valid and deserve careful consideration.

Firstly, it is important to understand the role of your medications. The heart rhythm medication you are taking is likely a beta-blocker, which is commonly prescribed to manage symptoms of palpitations and to help regulate heart rate. Beta-blockers can indeed lower blood pressure as they work by blocking the effects of adrenaline on the heart and blood vessels, leading to a decrease in heart rate and blood pressure. This mechanism can be beneficial for someone experiencing palpitations, but it can also lead to lower blood pressure readings, especially if you are already predisposed to lower blood pressure due to other factors, such as your hyperthyroidism.

Your home blood pressure readings averaging around 90-100 systolic and 65-75 diastolic are indeed on the lower side, especially when compared to the readings taken at the hospital, which are more in line with normal ranges (115/80). This discrepancy could be due to several factors, including anxiety, the time of day, or even the position in which you take your readings. It's also worth noting that home blood pressure monitors, while useful, can sometimes yield different results compared to clinical measurements.

Regarding your symptoms of fatigue and palpitations, it is essential to consider that hyperthyroidism itself can cause increased heart rate and palpitations. The thyroid hormone excess can lead to a hypermetabolic state, which may contribute to feelings of fatigue, especially if your body is working harder than normal. The heart rhythm medication may help manage the palpitations, but if you are experiencing persistent fatigue, it may be worth discussing with your healthcare provider whether your thyroid levels are adequately controlled.

As for your concerns about whether to continue taking the heart rhythm medication, it is crucial to consult with your healthcare provider before making any changes to your medication regimen. Stopping the medication abruptly can lead to a rebound effect, potentially worsening your palpitations or causing other complications. Your provider can assess your current symptoms, review your blood pressure readings, and determine if any adjustments to your medication are necessary.

In summary, managing your palpitations and blood pressure requires a comprehensive approach that considers your overall health, medication effects, and the underlying condition of hyperthyroidism. It is advisable to maintain open communication with your healthcare provider, who can guide you in making informed decisions about your treatment plan. Regular monitoring of your blood pressure and heart rate, along with periodic evaluations of your thyroid function, will help ensure that you are receiving the most appropriate care for your condition.

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