Low Pulse and High Blood Pressure

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Low pulse and high blood pressure are not typically seen together. When a doctor sees a low pulse rate, he typically sees it along with low blood pressure and when he sees high blood pressure he typically sees a high pulse or a normal pulse. However, there are a few medical conditions that can cause both of these to occur at the same time.


There are a few types of medications that may cause both of these. Beta-blockers are a type of medications, that even though they are sometimes prescribed to lower blood pressure, can raise blood pressure and lower heart rate. Acebutolol, bisoprolol, nadolol, propranolol, atenolol, metoprolol and nebivolol are commonly prescribed beta-blockers.

Sick Sinus Syndrome

This condition is actually a collection of heart rhythm disorders, including tachycardias, sinus bradycardia and bradycardia-tachycardia. Symptoms may include angina or chest pain, fainting or coming close to fainting, dizziness or feeling lightheaded, shortness of breath, confusion or mental status changes, fatigue or heart palpitations.

Some patients will not need treatment. If symptoms are bradycardia-related, an implanted pacemaker may be necessary. If symptoms are tachycardia-related medications or radiofrequency ablation are often effective.

Atrial Fibrillation

Atrial fibrillation is characterized by the heart’s two upper chambers quivering. The heart rate is irregular, and in many cases, rapid. This condition may be chronic or occasional. Symptoms may include heart palpitations, weakness, confusion, chest pain, feeling lightheaded and shortness of breath.

This condition is treated by resetting the heart rate to normal. This may be done through cardioversion with drugs or electrical cardioversion. Anti-arrhythmic drugs are given to maintain a normal heart rhythm. These often include dronedarone, amiodarone, sotalol, propafenone, flecainide and dofetilide.

Heart Attack

A heart attack may cause a low pulse and high blood pressure. A heart attack is characterized by insufficient oxygen getting to the heart due to blocked blood vessels. Also known as a myocardial infarction, the heart muscle can either become damaged as a result or the heart muscle can die. A heart attack is a medical emergency. Anyone experiencing the signs and symptoms should call 911 immediately. Chest pain that may radiate is the most common symptom. It may feel tight, heavy or squeezing, or like bad indigestion. Other symptoms may include cough, feeling lightheaded or dizzy, heart palpitations, anxiety, fainting, sweating, nausea or vomiting and shortness of breath.

Associated arrhythmias may be life-threatening and are commonly treated with electrical cardioversion/defibrillation or medications. Patients will be given oxygen and intravenous fluids, as well as have a urinary catheter inserted. Clot-busting drugs are often used. Other treatments may include angioplasty and stent placement, coronary artery bypass surgery and other medications, such as nitroglycerin, antiplatelet medications, narcotic or opioid pain medications, aspirin, beta-blockers, lipid-lowering medications and ACE inhibitors.


American Heart Association. (2011). What is Atrial Fibrillation? Retrieved on March 22, 2011 from the American Heart Association: https://www.americanheart.org/presenter.jhtml?identifier=4451

MedlinePlus. (2010). Sick Sinus Syndrome. Retrieved on March 22, 2011 from MedlinePlus: https://www.nlm.nih.gov/medlineplus/ency/article/000161.htm