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Medical Forum / General / Cardiology / November 2007ACE Inhibitors and Beta Blockers
I am a health conscious 63-year old male who experience a surprised heart attack 11/14/2007 due to coronary artery blood clot. After emergency angiogram, angioplasty and stent placement, I felt quite good but now after 10+ days on heart meds I have some concerns. My historic blood pressure readings have been 110s/70s. Readings now on Lisinopril (ACE inhibitor) and Metoprolol (Beta-blocker) are 90s/ 60s with average pulse rate 98. I am experiencing an increased tendency for postural hypotension (dizziness rising after squatting) and on awaking tingling in my hands that feel like I had slept on them but impossible for both hands. Should I be on these two drugs? Thank you for your responses, Roy > I am a health conscious 63-year old male who experience a surprised > heart attack 11/14/2007 due to coronary artery blood clot. After [quoted text clipped - 10 lines] > > Should I be on these two drugs? You should be telling your doctor that your bp is too low and it's making you dizzy and numb. If you're going to quit taking one on your own, make it the beta blocker; they cause diabetes, which promotes cardiovascular disease. Susan Susan <nevermind@nomail.com> wrote in part: >x-no-archive: yes > [quoted text clipped - 19 lines] > >Susan Post infarct with a pulse rate of 98 tells me not to discontinue the beta blocker on my own. -- Jim Chinnis Warrenton, Virginia, USA > Post infarct with a pulse rate of 98 tells me not to discontinue the beta > blocker on my own. > -- I definitely agree that calling the doc is the first thing to do, which is why I suggested it. But high pulse rate is often caused by hypotension. Susan Susan <nevermind@nomail.com> wrote in part: >x-no-archive: yes > [quoted text clipped - 4 lines] >I definitely agree that calling the doc is the first thing to do, which >is why I suggested it. But high pulse rate is often caused by hypotension. It would seem safer to discontinue the ACE inhibitor; sudden discontinuation of the beta-blocker could send the pulse rate even higher. It's entirely possible that the patient will wind up--after careful medical evaluation--on just a low dose of the ACE inhibitor. But we don't know if there were specific reasons for the beta blocker (aside from being post-infarct, which I don't think is a great reason by itself). -- Jim Chinnis Warrenton, Virginia, USA > It would seem safer to discontinue the ACE inhibitor; sudden discontinuation > of the beta-blocker could send the pulse rate even higher. I think the safest thing is to reduce, not suddenly stop, the beta blocker, as you know, but I did fail to mention it. I'd stop the more proven harmful drug first. Susan Susan <nevermind@nomail.com> wrote in part: >x-no-archive: yes > [quoted text clipped - 3 lines] >I think the safest thing is to reduce, not suddenly stop, the beta >blocker, as you know, but I did fail to mention it. I know you know it. > I'd stop the more >proven harmful drug first. If I were the patient, and knowing only what I know about him here (not much!), I'd prefer to stop the ACE inhibitor and let my BP rise and see if my pulse rate dropped. If it did, I'd try to taper off the beta-blocker and maybe substitute some ACE inhibitor if my BP rose too much. I'm not a physician, in case there were any doubt. -- Jim Chinnis Warrenton, Virginia, USA > x-no-archive: yes > [quoted text clipped - 6 lines] > > Susan Thank you Susan & Jim, I've moved up my first post-hospital cardiology follow-up appointment to tomorrow. Roy http-mart <pcis@775.net> wrote in part: >> x-no-archive: yes >> [quoted text clipped - 13 lines] > >Roy Great idea. I've gone through a high pulse rate (sinus tachycardia) following open heart surgery, and I know it's a lousy way to feel. The sooner you get the meds right, the sooner you'll be feeling good. Incidentally, Susan and I argue a lot, but have great respect for each other's views and thinking. If you read our exchange on this topic carefully, you should be able to see that we are sort of agreeing despite the argumentation. I hope that makes sense! -- Jim Chinnis Warrenton, Virginia, USA > Great idea. I've gone through a high pulse rate (sinus tachycardia) > following open heart surgery, and I know it's a lousy way to feel. The > sooner you get the meds right, the sooner you'll be feeling good. Definitely. > Incidentally, Susan and I argue a lot, but have great respect for each > other's views and thinking. If you read our exchange on this topic > carefully, you should be able to see that we are sort of agreeing despite > the argumentation. > > I hope that makes sense! I'm not sure it even makes sense to me, now that I see it on my screen. ;-D Susan > Thank you Susan & Jim, > > I've moved up my first post-hospital cardiology follow-up appointment > to tomorrow. > > Roy Very wise move, Roy. Susan > > > Post infarct with a pulse rate of 98 tells me not to discontinue the beta > > > blocker on my own. [quoted text clipped - 9 lines] > I've moved up my first post-hospital cardiology follow-up appointment > to tomorrow. That would be wise, Roy. May GOD bless you in HIS mighty way making you healthier (hungrier) than ever: http://HeartMDPhD.com/HolySpirit/BeBlessed Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. UPDATE - First Post-Heart Attach Cardiology F/U Appointment The cardiologist today explained that although Lisinopril and Metoprolol are primarily for lowering blood pressure they are also prescribed for post-heart attack recovery of the heart. None-the-less after hearing the symptoms I'm experiencing she changed Metoprolol to Carvedilol (Cogar), 3.125 mg 2x day and said if my blood pressure doesn't begin to rise to my normal levels by next week she will take me off Lisinopril. Overall, it felt good to get confirmation of what I had researched and learned here in this great news group and I can now see the light at the end of the recovery tunnel. Thanks for all your inputs and concerns, Roy It seems to me I heard somewhere that Roy wrote in article <1e83f7f1-7f25-4212-bc57-fc52b594eb9b@i12g2000prf.googlegroups.com>: >UPDATE - First Post-Heart Attach Cardiology F/U Appointment >The cardiologist today explained that although Lisinopril and >Metoprolol are primarily for lowering blood pressure they are also >prescribed for post-heart attack recovery of the heart. >None-the-less after hearing the symptoms I'm experiencing she changed >Metoprolol to Carvedilol (Cogar), 3.125 mg 2x day and said if my blood >pressure doesn't begin to rise to my normal levels by next week she >will take me off Lisinopril. >Overall, it felt good to get confirmation of what I had researched and >learned here in this great news group and I can now see the light at >the end of the recovery tunnel. >Thanks for all your inputs and concerns, I'm glad, and I'm sure others join me, to hear that you have a responsive doctor - that's the kind you want to hold on to. And thanks for the feedback; that's an important part of life in newsgroups.  SignatureDon Kirkman > UPDATE - First Post-Heart Attach Cardiology F/U Appointment > [quoted text clipped - 13 lines] > Thanks for all your inputs and concerns, > Roy You are welcome, Roy :-) Redirecting all thanks, praise, and glory to GOD, Whom I love with all my heart, soul, mind and strength. Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. It seems to me I heard somewhere that http-mart wrote in article <66724dec-be53-4074-bb39-9200d2008a9a@e23g2000prf.googlegroups.com>: >I am a health conscious 63-year old male who experience a surprised >heart attack 11/14/2007 due to coronary artery blood clot. After >emergency angiogram, angioplasty and stent placement, I felt quite >good but now after 10+ days on heart meds I have some concerns. >My historic blood pressure readings have been 110s/70s. Readings now >on Lisinopril (ACE inhibitor) and Metoprolol (Beta-blocker) are 90s/ >60s with average pulse rate 98. >I am experiencing an increased tendency for postural hypotension >(dizziness rising after squatting) and on awaking tingling in my hands >that feel like I had slept on them but impossible for both hands. >Should I be on these two drugs? >Thank you for your responses, You should be addressing this question to your cardiologist. Newsgroup members, not knowing your history, the details of your intervention, or your doctor's plan for treatment, can only give you glimpses of their own experience, which may be very different from your own optimal treatment. Bearing that in mind, your historic blood pressure readings are a good bit lower than mine were before my 1998 mild attack. With Lisinopril, atenolol, and statins my pressure now runs about 80~90 systolic, 65~85 diastolic. My pulse rate is below most people's, but your 98 seems rather high to me. I'd have to be walking pretty fast to maintain at that level. SignatureDon Kirkman > I am a health conscious 63-year old male who experience a surprised > heart attack 11/14/2007 due to coronary artery blood clot. Sad to read about this happening to you 12 days ago. You are blessed to be alive since many don't survive their first one. Health conscious folks having a heart attack while taking aspirin does take us by surprise. > After > emergency angiogram, angioplasty and stent placement, I felt quite > good but now after 10+ days on heart meds I have some concerns. Understandably. It would be 12 days on heart meds. > My historic blood pressure readings have been 110s/70s. Readings now > on Lisinopril (ACE inhibitor) and Metoprolol (Beta-blocker) are 90s/ [quoted text clipped - 5 lines] > > Should I be on these two drugs? It seems you have been overmedicated. Would suggest you inform your cardiologist about your symptoms. It is likely s/he would opt to decrease the lisinopril or stop it altogether. > Thank you for your responses, > Roy You are welcome, Roy :-) Redirecting all thanks and praises to GOD so that we will both be that much more blessed (hungrier): http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. |
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