Would Metoprolol help my blood pressure?

by Rose

Cardiologist keeps wanting to put me on Bp medication because when I visit their office it is always high over 140/90. However when I take my bp at home using a bp machine that takes 3 readings and then avg them to give me a reading and/or single readings it isn't perfect but it is not very high. Here are my current readings...111/68 hr 56..128/67 hr 57...132/77 hr 60... 123/73 hr 63.... 128/69 hr 63...130/71 hr 73.. 110/70 hr 58.. 122/71 hr 62...133/74 hr 62 ...130/71 hr 62...128/72 hr 65....135/73 hr 66 (Readings were taken from 7-27 to 8-19)

I suffer for over 8 years of having chest pain in which all the heart studies know to women have been done. I had in the past 5 years, holters, two caths, lots of EKG showing low R progression with no changes, ct calcium score with zero score, two thallium stress test, and several echo stress test with one as recent as last month. All normal except for BP at the drs office. I am overweight (gone from197 to 185) and still going to work on this (on no to low salt and low carbs) and menopause female. My cholesterol was good one month and a month later I was at 222 total with HDL 52 trig 66 and LDL 143. i still have numerous strong beats (PVCS) occasional flip flops, but the cardiologist are not alarm. I had sleep studies also negative. MRI of my brain normal. Had a a scan of my arteries of my neck negative. Bone scan normal but still I complaint. My question is how will 25 mg of metoprolol (tropol xl) affect my pressure at home and will my heart rate which tends to get lower 60 bpm cause me more trouble than my bp?

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Aug 27, 2013
Metoprolol and blood pressure
by: Neil

Hi Rose,

Thanks for your submission. It is clear you are meticulous and it's good your taking your health seriously.

A blood pressure of 140/90 is considered high but within normal limits. The question I have is how high does the Blood pressure go? How high is your Heart rate while at the doctors office? Does the doctor check your blood pressure just after walking in the office or after you have time a chance to sit for a bit and relax?

If your BP is high with a high HR, my first thought is that you have white coat syndrome or stress. Very simply, anxiety or stress is playing a large role with your BP.  If your BP is high with a lower HR then it isn't anxiety but rather borderline hypertension.

Blood pressure changes from minute to minute and hour by hour. So it's imperative to take your blood pressure the same time everyday. Checking it in the morning one day and in the evening the next would give different results.

With every beat of your heart, the heart exerts pressure on your blood vessels this is your upper BP reading or systolic BP. As your vessels relax and go back to normal, the vessels exert pressure on the blood and this is your bottom BP reading or diastolic BP. There is a direct correlation with heart rate and blood pressure. The faster the heart races the higher the BP goes and of course the opposite is true. The lower the heart rate the lower the blood pressure.  Metoprolol works by lowering the heart rate and keeping the blood pressure lower. The goal of treatment is to keep the heart rate as close to 60 bpm without going too far under as this may cause dizziness and passing out (syncope).

I took the liberty in calculating your 10 year heart risk score. With a BP of 140 systolic your risk of developing heart disease in 10 years is 7.3%. Conversely, with a systolic BP of 110 your score is cut in half to 3.3%. I made some assumptions that you do not smoke, do not have diabetes and are around 50 years of age. So these numbers may not be accurate for you exactly but it clearly shows that controlling your blood pressure is vital in reducing your risk of developing heart disease.

Controlling your heart rate could help with your chest pains as there could be a direct correlation.

My advice would be to share your results with your cardiologist. Take your blood pressure machine with you on your next visit and compare your BP results with the doctor. If it turns out your machine is inaccurate then your results would be deemed inconclusive, but if it turns out your results are accurate, then going on metoprolol could put your heart rate lower than 60 bpm and thus put you at risk for dizzy spells and syncope.

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