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Can high blood pressure cause a low heart rate?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I had high blood pressure and a low heart rate. Does my ECG indicate an infarction? I do not have any chest pain. At the time of the ECG, my blood pressure was 168/100 mmHg, and my heart rate was 46 beats per minute.

Please help.

Hi,

Welcome to icliniq.com.

I have reviewed your ECG (attachment removed to protect patient identity). The findings mentioned on the ECG are machine-generated and can often be inaccurate. There is no clear evidence of myocardial infarction on the ECG. Since you do not have a history of chest pain, a heart attack is unlikely. However, your heart rate is low, indicating sinus bradycardia. Do you have any symptoms such as dizziness or syncope? If not, no immediate action is needed.

I recommend that you undergo a thyroid test to rule out hypothyroidism as a possible cause of the low heart rate. An echocardiogram (echo) should also be performed to provide additional assurance and rule out myocardial infarction (MI). If the echocardiogram results are normal, a treadmill test (TMT) is advised. This will help rule out minor blockages, and subclinical ischemic heart disease, and determine the maximum heart rate achieved during exercise, which can confirm the benign nature of sinus bradycardia if an adequate heart rate is reached.

Additionally, high blood pressure can lead to a low heart rate through a reflex mechanism, so it is important to manage your blood pressure. I assume you are not currently taking medications like beta blockers, which can lower the heart rate. For hypertension, you may consider taking a combination of Telmisartan and Chlorthalidone once daily in the morning. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent.

Regards.

Patient's Query

Hi doctor,

Thank you for the reply.

Are there any good substitutes for Telmisartan and Chlorthalidone? I do not have insurance.

Hi,

Welcome back to icliniq.com.

Alternatively, you may take Amlodipine 5 mg once daily in the morning, with the dosage increased later if needed, but only with a doctor's prescription.

Thanks and regards.

Medically reviewed byDr. K. Shobana

Published At August 20, 2018
Reviewed AtNovember 4, 2024

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