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   What is too low for BP? (Heart Disorders board)

17th November 2006
My cardiologist has me keep my BP around 90/50 with Metapropolol 100mg bid, Monopril 10mg at bedtime and Moduretic 5/50mg in the morning. We settled on these dosages in April of 2004 and I was free of angina pain until last month. In October, I had one incident of angina while running through Charles De Gaulle Airport to catch a flight. I have since talked to my cardiologist and he told me to take 50mg of Metapropolol between the two regular doses if I expect any physical stress.

Sometimes my BP gets as low as 84/38, especially at night, when I am in bed. It has been as high as 110/60 since starting the regimen. But before I started taking the meds, my BP after one minute of squeezing an instrument that measures the grip and hold my arm in the air, was 180/130.

I do have two coronary arteries that are 100% blocked and three that are 85% or more blocked. The cardiologist that discovered the CAD wanted to do an immediate CABG back in 2004. He said I was a walking time bomb and would have a heart attack within weeks if I didn't have the surgery. He had also said my heart was in "great shape." I asked, how can my heart be in such great shape if the arteries that provide oxygen to it are so clogged. He wouldn't tell me and I wouldn't let the cardio-thoracic surgeon he wanted to use cut on me until I got a second opinion.

The noninvasive cardiologist I turned to did several tests, including echocardiogram, doppler, and other noninvasive diagnostic tests. He admitted my arteries were blocked, however, he said that was not the cause of my angina and went on to show me it was the hypertension on exertion that caused the angina. As for the CAD, he said, don't worry about it. The medication he put me on woulf allow the body to use collateral vessels to supply my heart with oxygen while my own body creates alternate vessels through a process called angiogenesis.

Now, two and a half years after starting the regimen, my heart is in better shape than before, based on an Ejection Fraction that went from 49 to 72 in a year and further exams provided each year. I feel great, the time bomb didn't go off in a matter of weeks,, I am working full time at a very lucrative job and have never felt better.
17th November 2006
Quote from kenkeith:
Not unlike my experience. I have a totally blocked LAD, but there are collateral vessels and angiogenesis from the RCA that feed the area deficit from the blockage. What is the medication?

Just the metapropolol, monopril and modiuretic. My BP maintains at 90/50 and my pulse between 50 & 60. The cardiologist says this creates less turbulence through the impaired arteries so there iss less chance of a clot breaking loose and over time collaterals and angiogenesis replace the bad arteries.
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