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Nephrologist, Doctor
Category: Medical
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Experience:  Board Eligible Nephrologist
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I am an 81 year old woman. My blood pressure ranges from 125

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I am an 81 year old woman. My blood pressure ranges from 125 to 135 systolic, and from low 60s to l0w 70s for the other value. My concern is a low pulse rate, that can be as low as 48-50 in the morning. I am reasonably fit for my age but certainly not an athlete. Is this normal?

I might add that my regular doctor just retired and I saw the person he sold his practice to, but she did not seem concerned about the pulse rate
Submitted: 4 years ago.
Category: Medical
Expert:  Nephrologist replied 4 years ago.

I am a hypertension specialist. Your relatively low heart rate seems to be a variant of normal. Low pulse, just like low blood pressure, is only worrisome if it causes symptoms. These symptoms include lightheadedness, dizziness, vision blacking out, unsteadiness on your feet, etc. If these are absent, the heart rate is usually acceptable to be at this level. If I were your doctor, I would do an EKG to see if you have a normal heart rate that is just slow (so called sinus bradycardia), or a more worrisome types of slow heart rate (such as bundle branch block, junctional rhythm, etc.) The latter are more worthy of close attention, but also are not too concerning if they are not causing symptoms.

Also, certain medications such as beta blockers (metoprolol, carvidelol, bystolic) and calcium blockers (diltiazem) can slow down heart rate. If you are on these, these may be discontinued if needed.

So overall, dont worry. If you feel fine, the levels of low heart rate are not concerning. What is too low? Medicare will pay for a pacemaker only if heart rate falls below 40. So that could be your guide.

Hope that helps (that'd be a $250 consult for $7.50 ;) )
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