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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10341
Experience:  14 years experience in the field of Family Practice
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I have been taking Atenolol as needed

Customer Question

I have been taking Atenolol as needed for years for arrythmia usually a smaller dose than 25 mgm daily. Recently my blood pressure has been spiking with the diastolic 90 and 100. The doctor has added 5 mgm daily of Lisinopril. I have felt unwell before and after the therapy.
My symptoms usually involve the arrythmia and a spike in bp and a general feeling of unwellness. I am 78 years old, 120 lbs and have always exercised. I do not smoke and my blood work is perfect.
I am new to the FL area and have not really established a connection with a cardiologist or internist. I have been told by other Doctors over the years that I have a murmur, but it is functional and I did not have Rh fever. The Dr. here said I did have Rh fever and have some regurgitation and one of the ventricles is thickened.
I am not able to function as I would like and feel somewhat alone in this new habitat. My late husband was a Radiologist and I have 2 sons who are physicians, but are far away. Any advice or help you may offer would be greatly appreciated.
Submitted: 2 years ago.
Category: Medical
Expert:  Anthony Bray, MD replied 2 years ago.
Hello!I would think that you taking the Atenolol DAILY would be a good start....a daily beta blocker is first line to help reduce most heartvarrythmias and to help to treat high blood pressure.Your age even healthy is common to see rising blood pressure trends...the renal function that we have steadily declines as we age even with healthy habits. You would want to keep BP ( seated average and check outside doctor's office ..10 minutes rest first ..You may get your own BP cuff at pharmacy..I like the ones that read at the wrist ) ---check and keep AVERAGE of 15 or 20 such readings is most accurate!!You want your BP average to be between 100 to 135 systolic and 60 to 85 diastolic on average... Regular exercise and low salt ( sodium) diet are to your advantage.... Even with great health habits the natural reducing efficiency with age of the kidneys will very commonly be associated with hypertension changes. This does not mean that you have done anything wrong. I think a holter monitor to watch your heart rhythm on medication for 24 hours would be indicated if that has not yet been done...A cardiac ultrasound should be done to check the structure of the heart. I am not saying that you have had rheumatic fever. You could have a number of changes such as left ventricular hypertrophy or valve changes over the years ( mild mitral regurgitation for example could lead over time to left atrial enlargement...You could feel fine and be healthy and maintain good habits and have such slow steady changes ...It would not mean that you have done anything wrong!!) The BP changes and need for treatment are common. I like other options vs ACE inhibitor(Lisinopril) such as,A2 receptor blocker perhaps your beta blocker...daily beta blocker alone would make sense as start... Adding mild diuretic may be of help ..low dose of HCTZ would be very inexpensive and mild in nature for example .. You may benefit with rhythm disturbance of heart to try daily magnesium supplement...these are easy to obtain over the counter magnesium oxide 250 to 400mg once a day is harmless and tends to stabilize heart rhythm...discuss with your cardiologist!!! The thickened ventricle sounds due to increased pressure over time...the beta blocker helps to treat also ACE inhibitor ( or A2 receptor blocker) would help to treat that change..... I hope that this information is helpful for you!! Let me know if you have further questions or discussion.I will be happy to get back with you! If my answers have been helpful and to your satisfaction then please remember to leave positive feedback.Thank You and Best Regards,ANTHONY BRAY MD