Intermittant Hypertension?

[MommaH943]

I am a 34 yr old woman.  I have 2 children.  I am 5'6" and weigh 135 lbs.  (so, within normal limits)  I have a history of smoking.  I quit 7 months ago.  I had pregnancy induced hypertension at the end of my first pregnancy which resolved at the birth of my child.  I also had hypertension immediately following the birth of my 2nd child that resolved in a couple of weeks.

A few months ago I had two episodes of hypertension while at work 177/112 and 160/100.  I was working a night shift both times and had drank an energy drink.  Both episodes the elevated BP was accompanied by a headache and lasted several hours.  I visited my Dr. following these episodes and she thought it was the energy drink causing the high BP.  Since then I quit drinking energy drinks and even quit drinking caffeine regularly.  ( I now have no more than one caffeinated beverage a week).

Since then I have checked my blood pressure periodically and it is usually around 120/78.

Two nights ago I was walking around the house and felt my heart skipping around.  I have felt palpitations before, but they always went away right away.  I continued to feel these palpitations so went in to the ER.   EKG showed Premature Junctional Contractions.  Dr. stated that these were harmless.  Blood work all came back negative.  But, BP was elevated between 150/100, 165/121, and 180/111.  I was given Toprol 25mg, which I have taken daily since.  

My blood pressure has normalized, but the heart palpitations continue now more than 36 hrs later.  

My question is What will cause sudden onset of heart palpitations?  and What would cause intermittant high BP?  I did not feel anxious, and would anxiety cause BP to elevate that high?  

[is_something_wrong]

Hello,

First, the premature junctional contractions (PJC). Those are less common than premature atrial contractions (PAC) and premature ventricular contractions (PVC). They can also feel a lot worse, because the atrias and ventricles contract simultanously (you get an impulse from "the middle" of the heart that fires both up and down), creating a weird sensation. They are still benign, and nothing to worry about (like your doctor told you).

Stress will increase the blood pressure. My blood pressure is usually on the low side of normal (I've measured as low as 105/49) but at the doctors office it's at least 140/90. If measured by a cardiologist it's 150/90. If measured while connected to EKG, it's 160/110.

A friend of mine went to the ER with severe back pain. His blood pressure was 210/120.

Answer is; yes, the blood pressure is supposed to increase with mental and physical stress. What is important, is a normal resting blood pressure (and of course, you shouldn't be stressed 12 hours a day). Heart rate and blood pressure (which have nothing to do with each other, you can have high blood pressure with low heart rate and vice versa) is really like an engine. I'm sure you drive at 5000 RPM sometimes, and that's not a concern. You shouldn't drive at 5000 RPM at all times, however. The fact that your body is able to increase blood pressure when needed (though the body and you have different definitions of when "needed" is) demonstrates your hemodynamic reserves. It's actually a good thing.

Blood pressure tends to increase when you are afraid that it's high on tests. You get a sensation like "oh s*** what will my blood pressure be this time" which is a major trigger for high blood pressure during the test.

[annie1724]

Thanks, Cindy!  That makes me feel better. My doctor seems to like the atenolol, so I have to trust him and  go with his judgement, but when you read this stuff online it does kind of scare you, so it's nice to talk to someone with first hand experience.  Guess I'll have to bite the bullet and go for it!  After 15 years on verapamil, I shouldn't be so concerned about this, I know.  I still just think I'm resisting cause I had hoped to be off all medicine after the ablation!  Oh well, there are much worse things than taking a daily beta blocker, so time to just do it!

[cindy707]

Hey Annie...no i still have a full head of hair (thank GAWD!!!) and haven't gained any weight other than the normal holiday eating frenzy that i went on a couple of days ago.  I haven't had any side effects from the antenolol at all since i was put on it.  You have to remember that the doc tried me on a couple of other meds first...Toprol (not good had too many side effects), Inderal (again all i wanted to do was sleep) and i really can't remember what else but we went thru a couple of them until we touched down on the Antenolol.  I am on the same dosage as you are going to be put on and have had absolutely zero side effects and didn't get tired at all.  The only issue that i did have with it was by my own doing...as with all beta blockers Annie or heart meds you can't just stop them suddenly and i had a three day period where i didn't take the meds and wasn't too worried about it...i knew i would be re taking it on the 4th day...i got busy, left town, left the pills by mistake...on the nite of the 3rd day i had total re bound which is a normal occurance when you suddenly stop taking them...my heart wreaked havoc on me...i went into a pretty nasty case of atrial fib...went to the hospital.....had to be converted.....end of story.  No atrial fib since and i make sure the meds go with me wherever i go now....its true what they say that you have to be slowly weaned off of them because they are blocking the adrenaline and once you suddenly stop taking the meds the flood gates open up with the adrenaline...i knew better, thought i was different, got too comfortable in my comfort zone and now i sit up and listen. The Antenolol is great for an all around beta blocker and the lowest in the family of blockers so its not like you are getting the big gun of meds like Multaq....with a b/p that is minimally high like yours and dealing with PAC's (been there done that) antenolol has been my saving grace......so as far as i am concerned it is a med that is on the top tier of efficiency with the least amount of side effects.....hope it works for you Annie personally i love the stuff and use it as my safety net since the ablation.....

[annie1724]

Hi Cindy,

I have a question for you regarding Atenolol.  You may recall I have been resisting the doctor's recommendation to take this to subdue my PACs  because they really aren't bothering me at all and  I was just so glad to be off heart meds after my ablation. (And my doc was willing to let me make the call cause the atenolol was only for symptomatic relief anyway.) Well the palps are still there occassionally but not really bothering me now that I know they are nothing to worry about, but my blood pressure has been a little high since October (140/90) and the doctor wants me to start on the Atenolol .25 mg to cover both issues.  So my question for you......how are you doing with the atenolol?  Sounds like you are taking the same amount for the same issues as me.  Are you having any problems with side effects?  The doc said I might experience fatigue for the first week or two, but that I should get used to it after that.  But I have been reading online about the side effects that people complain about and I am somewhat concerned.  I don't want to be tired all the time.....No time for that!!  Also have seen people on this forum mention gaining weight and thinning hair...UGH!!!  Have you had any of that??

MommaH943, I hesitate to comment on your high blood pressure, not having any medical knowledge, but it sure seems like your heart racing and palpitations could be related to your high blood pressure.  You said you weren't anxious, but just being in the ER is nervewracking...not to mention your racing heart!  hopefully your doctor can clear things up for you.

Annie

[MommaH943]

Thank  you for your insight.  I guess I am curious if my blood pressure and these palpitations are related.  I hope to get an appt with the Dr in the morning.

As for writing down when they are happening...they are happening constantly.  This morning I am finally getting a few minutes of relief here and there.  Yesterday and the night before, I did not have one minute in which I did not have extra beats.  That's why it is bothering me, it has not stopped....and since I can feel everytime it happens, it has been a constant issue for a day and a half.

[cindy707]

Most docs say that palps are benign but i think alot of us would differ with that one.  Generally palpatations are electrical based in the heart in most cases meaning that your heart is the main pump of the body and it means that it fires off by a very specific electrical pattern the runs pretty much the length of the heart .  Sometimes the electrical misfires due to alot of things....consuming certain food groups, stress, anxiety, physical, who knows what but if the heart begins to misfire and doesn't re set itself which it normally does you get prolonged episodes which can be scary.  At that point the doc i think needs to take a closer look...it could simply be that the Toprol is not the med for you and is not catching the palps but is taking care of the b/p.  Some beta blockers work for both and some don't work as well depending on our bodies.  I had a similar situ w. the fast irregular pulse and higher b/p and the doc originally put me on Toprol as well but i kept having "breakthroughs" w. my heart and he switched me to Antenolol which caught both the b/p and stablilzed the heart.  As far what causes intermittant high blood pressure sounds to me like one of those process of elimination things that you need to do to eliminate specifics to see what is raising it.  And yes stress and anxiety def. play a key role in hypertension however it could be something as simple as the food you are putting into your mouth,.Anything with a high salt content or alot of electrolytes in them can cause hypertension.  As far as having issues with being closely monitored while you were pregnant and skirting that situ it is pretty unfortunate but probably doesn't have much to do with what you are going thru now.  I was one of the lucky ones when i was pregnant...i didn't have issues with it with my kids but i have friends who have and it is scary as all get out.  I would just stay proactive with this and maybe take a pad of paper and start writing down when the palps are happening and see if you can isolate the incidences by way of a journal for a couple of days....but like i said it may just be that the meds aren't effective for you anymore...good luck