High Pulse

#1 12-17.-2003

I am a Type 2 diabetic on diet and exercise. My BG's are in the non diabetic territory. A couple
weeks ago my GP recently put me on Altace 5 mg for kidney protection and Lipitor for high
cholesterol.

The problem is I am seeing a high pulse rate. I measure my BP at least twice daily. Since about the
first of the year my systolic and diastolic are on a somewhat of a decline. The pulse was also on a
rough decline. When a person looks at a graph the systolic decline is quite obvious. The diastolic
and pulse are almost flat. That is until about the middle of August. The pulse went from about 80
range to now bouncing in the 90's. My GP put me on Altace on the end of August.

I saw the GP couple weeks ago when I first observed the pulse bouncing in the low 80's. He said that
was no big deal. I'm a tad concerned.

Here is my BP stats for the past 30 days Systolic 122 high
105.8 Avg 90 low Diastolic 76 high
106.9 avg 53 low Pulse 96 high
107.4 avg 73 low

My question is Why isn't Altace keeping the pulse rate down?

What is causing this increase in pulse rate?

Should I ignore my GP and see a cardiologist?

#2 12-17.-2003

Giggles@Headache.com wrote:

> I am a Type 2 diabetic on diet and exercise. My BG's are in the non diabetic territory. A couple
> weeks ago my GP recently put me on Altace 5 mg for kidney protection and Lipitor for high
> cholesterol.
>
> The problem is I am seeing a high pulse rate. I measure my BP at least twice daily. Since about
> the first of the year my systolic and diastolic are on a somewhat of a decline. The pulse was also
> on a rough decline. When a person looks at a graph the systolic decline is quite obvious. The
> diastolic and pulse are almost flat. That is until about the middle of August. The pulse went from
> about 80 range to now bouncing in the 90's. My GP put me on Altace on the end of August.
>
> I saw the GP couple weeks ago when I first observed the pulse bouncing in the low 80's. He said
> that was no big deal. I'm a tad concerned.
>
> Here is my BP stats for the past 30 days Systolic 122 high
> 105.8 Avg 90 low Diastolic 76 high
> 65.9 avg 53 low Pulse 96 high
> 82.4 avg 73 low
>
> My question is Why isn't Altace keeping the pulse rate down?
>

It is not supposed to.

>
> What is causing this increase in pulse rate?
>

Lowered blood pressure can do it.

>
> Should I ignore my GP and see a cardiologist?

You should inform your GP about the above.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

#3 12-17.-2003

On Thu, 25 Sep 2003 15:33:54 -0400, "Dr. Andrew B. Chung, MD/PhD"
<andrew@heartmdphd.com> wrote:

>Giggles@Headache.com wrote:
>
>> I am a Type 2 diabetic on diet and exercise. My BG's are in the non diabetic territory. A couple
>> weeks ago my GP recently put me on Altace 5 mg for kidney protection and Lipitor for high
>> cholesterol.
>>
>> The problem is I am seeing a high pulse rate. I measure my BP at least twice daily. Since about
>> the first of the year my systolic and diastolic are on a somewhat of a decline. The pulse was
>> also on a rough decline. When a person looks at a graph the systolic decline is quite obvious.
>> The diastolic and pulse are almost flat. That is until about the middle of August. The pulse went
>> from about 80 range to now bouncing in the 90's. My GP put me on Altace on the end of August.
>>
>> I saw the GP couple weeks ago when I first observed the pulse bouncing in the low 80's. He said
>> that was no big deal. I'm a tad concerned.
>>
>> Here is my BP stats for the past 30 days Systolic 122 high
>> 105.8 Avg 90 low Diastolic 76 high
>> 65.9 avg 53 low Pulse 96 high
>> 82.4 avg 73 low
>>
>> My question is Why isn't Altace keeping the pulse rate down?
>>
>
>It is not supposed to.
>
>>
>> What is causing this increase in pulse rate?
>>
>
>Lowered blood pressure can do it.

Could you elaborate on this?
>
>>
>> Should I ignore my GP and see a cardiologist?
>
>You should inform your GP about the above.

I saw my GP a couple weeks ago, and showed him a graph of the rising pulse rate. He said don't worry
about it, said pulse of 80's and 90's are normal. A 60 day graph shows systolic in a somewhat
decline, diastolic in a erratic flat to decline pattern, and pulse in a rapid increase. Quite scary
since one would expect all three to decline.

As you can guess, on DM diagnosis, I also had hypertension. Cozaar really knocked it down. I no
longer take cozaar, but have some left. Could I add cozaar to the altace?

Thank you. The pulse worry's me.

#4 12-17.-2003

Giggles@Headache.com wrote:

> On Thu, 25 Sep 2003 15:33:54 -0400, "Dr. Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote:
>
> >Giggles@Headache.com wrote:
> >
> >> I am a Type 2 diabetic on diet and exercise. My BG's are in the non diabetic territory. A
> >> couple weeks ago my GP recently put me on Altace 5 mg for kidney protection and Lipitor for
> >> high cholesterol.
> >>
> >> The problem is I am seeing a high pulse rate. I measure my BP at least twice daily. Since about
> >> the first of the year my systolic and diastolic are on a somewhat of a decline. The pulse was
> >> also on a rough decline. When a person looks at a graph the systolic decline is quite obvious.
> >> The diastolic and pulse are almost flat. That is until about the middle of August. The pulse
> >> went from about 80 range to now bouncing in the 90's. My GP put me on Altace on the end of
> >> August.
> >>
> >> I saw the GP couple weeks ago when I first observed the pulse bouncing in the low 80's. He said
> >> that was no big deal. I'm a tad concerned.
> >>
> >> Here is my BP stats for the past 30 days Systolic 122 high
> >> 105.8 Avg 90 low Diastolic 76 high
> >> 65.9 avg 53 low Pulse 96 high
> >> 82.4 avg 73 low
> >>
> >> My question is Why isn't Altace keeping the pulse rate down?
> >>
> >
> >It is not supposed to.
> >
> >>
> >> What is causing this increase in pulse rate?
> >>
> >
> >Lowered blood pressure can do it.
>
> Could you elaborate on this?

Baroreceptors in the carotid sinus sense the decreased pressure and sends signals that lower vagal
tone. Less vagal tone increases heart rate.

>
> >
> >>
> >> Should I ignore my GP and see a cardiologist?
> >
> >You should inform your GP about the above.
>
> I saw my GP a couple weeks ago, and showed him a graph of the rising pulse rate. He said don't
> worry about it, said pulse of 80's and 90's are normal. A 60 day graph shows systolic in a
> somewhat decline, diastolic in a erratic flat to decline pattern, and pulse in a rapid increase.
> Quite scary since one would expect all three to decline.
>

Not if you understand physiology and the pharmacology behind the medications you are taking.

>
> As you can guess, on DM diagnosis, I also had hypertension.

Having diabetes does not automatically mean you have or will have hypertension.

> Cozaar really knocked it down. I no longer take cozaar, but have some left. Could I add cozaar to
> the altace?
>

Don't see a reason to since your blood pressure is well controlled according to the
information you give.

>
> Thank you. The pulse worry's me.

If you are losing weight, it may be time for your doctor to back off on some of the blood pressure
medications. Folks generally need less as they get lighter.

Are you visiting from ASD?

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

#5 12-17.-2003

On Thu, 25 Sep 2003 21:33:34 -0400, "Dr. Andrew B. Chung, MD/PhD"
<andrew@heartmdphd.com> wrote:

>
>>
>> As you can guess, on DM diagnosis, I also had hypertension.
>
>Having diabetes does not automatically mean you have or will have hypertension.

Upon dx about eighteen months ago, my BP was 170/118/124. The original GP I saw at that time put me
on Cozaar. I took Cozaar for about a month when the BP approached 117/68/78.
>
>> Cozaar really knocked it down. I no longer take cozaar, but have some left. Could I add cozaar
>> to the altace?
>>
>
>Don't see a reason to since your blood pressure is well controlled according to the information
>you give.
>
>>
>> Thank you. The pulse worry's me.
>
>If you are losing weight, it may be time for your doctor to back off on some of the blood pressure
>medications. Folks generally need less as they get lighter.

The GP put me on Altace about six weeks ago for kidney protection. The urine Microalbum U Random
test showed as 17.9 ug/mL. Slightly above the range of 0.1 - 17. The pulse started rising a
short time before starting Altace. A1c = 5.5, a year ago it was 5.4. Crazy blood sugars are not
the problem.

BP this morning was 101/65/92. I don't like that pulse, too high.