Pacemakers and beta blockers

I turned 79 yesterday. My PCP is a bit of a fanatic when it comes to BP, insisting that I keep it well below 130/70. I am past the point of trusting any doctors completely. The heart block that brought me to the ER two weeks ago was dismissed by the cardiologist as a error in the stress test that he ordered - despite previous tests that ALSO suggested a possible AV heart block. Looking back, I can think of other symptoms going back years that might be attributable to a growing AV heart block problem, Which is why I am now intent on adjusting my own mediations. This morning, my readings were a consistent 131/74 P75 after HALVING the Nebivolol pills for the last 2 days to 5mg/day vs the prescribed 10mg with a side of Losartan as needed. I'm sure my PCP would argue that it's still too high. I am shocked that people here are reporting keeping their systolic BP under 110. Anything less that 130 makes me feel like a dishrag, and under 110 I can barely stand up.

@jimgrupe May I add that your hydration level may have a bearing on your feeling like a dishrag (great description). I carry around a 32-ounce container and sip all day long. I am to drink 2 of these each day and avoid salty food. Ask your doctor about how much water you should drink every day.

@jimgrupe Welcome to Connect! I see you recently joined our discussion and are presently focused on BP (blood pressure) and various BP medications. We do not give medical advice on Connect but do share our experiences. Your cardiologist and electrophysiologist should be in the loop concerning your BP. While our PCP (primary care providers) are certainly excellent doctors, these other specialty doctors have more current knowledge and experience in their specific fields. My cardiologist oversees my blood pressure meds. @gloaming noted an important debate concerning blood pressure. There does not seem to be any definitive answer at this point, but I did see this by AI (scientific verification needed - it seems that studies at the UVA-University of Virginia are investigating):

"Why Targets Can Vary

Blood pressure management is highly personalized. Your doctor may adjust your "perfect" range based on specific factors: Underlying Conditions: If you have diabetes, chronic kidney disease, or a history of heart disease, your doctor will likely aim for a tighter control. UVA Health+4

Frailty & Medications: For some older individuals, aiming too low can cause dizziness or increase the risk of falls. In these cases, a slightly higher target may be chosen to balance safety and cardiovascular benefits.
IntraCare Health Center+3"

We highly recommend not changing any medications without consulting your doctor. A discussion and questions about age and BP readings may result in a more comfortable outcome for you.

@walkinggirl I have to admit, I'm not big on water. Other fluids fine, but plain water is just so...uh....*plain*. 🙂 Iced tea, soda, juices, etc. Gimme some flavor!!!!

But what is very clear to me is that the same dosage of Nebivolol before surgery is now much too strong, and I'm having difficulty understanding WHY.

I *think* that right now I am still feeling the effects of the surgery and need to give it a little more time. Although, my "Surgery" was rather minor: My pacemaker is a new variety that was implanted into the heart via a vein from my groin. No box. No incisions. No wires.

@walkinggirl "We highly recommend not changing any medications without consulting your doctor. "

Easier said than done. Can you believe this? Everyone is on vacation until August. The cardiologist I am leaving is out until August 10. The cardiologist I am changing to isn't available until August 12. My PCP is out until mid-July. They all have "coverage" by someone else, who knows nothing of my particulars, of course. I have a follow-up appointment with the surgeon who did the implant on July 30.

Fortunately, I am pretty well educated and am comfortable researching these things myself. The internet and sites like this one makes it relatively easy. I did get a message through to my vacationing cardiologist - or at least his office - who approved my resumption of the previous BP meds - which I had already done.

@jimgrupe Do you receive care at a COE (Center of Excellence)? Places such as those are known for good coverage and good communication among personnel. I do not go to one; there are none around where I live. At various times I see different professional staff at my cardiologist's office. When I have my appointment, I am amazed at how much someone (other cardiologists and PAs) I have never seen before seems to know all about my heart history. You deserve the best care possible.

@jimgrupe Do you receive care at a COE (Center of Excellence)? Places such as those are known for good coverage and good communication among personnel. I do not go to one; there are none around where I live. At various times I see different professional staff at my cardiologist's office. When I have my appointment, I am amazed at how much someone (other cardiologists and PAs) I have never seen before seems to know all about my heart history. You deserve the best care possible.