High Blood Pressure And Low Pulse Causes: What You Need To Know

Suffering from high blood pressure and low pulse rates can sometimes occur, but certain medications and medical conditions can increase the chances of the condition affecting you.

High blood pressure, also known as hypertension, occurs when the pressure of blood against artery walls becomes too high, which can cause damage to the heart and other body organs. 

High blood pressure leads to the stiffening and thickening of the heart muscle, making it hard for electrical impulses to be conducted through the thickened heart muscle tissue. As a result, your pulse might slow down, and your heart may not be able to beat as fast as it once did because it takes longer to transmit the electrical impulses within the heart.

Heart damage can cause a low pulse with high blood pressure, and, in some cases, medication or further treatment is necessary.

This article shares insights into the relationship between high blood pressure and low heart pulses. Read on to learn more. 

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What is a low pulse?

The term “low heart rate”, or bradycardia, refers to a situation when the heart rate – also called the pulse – is lower than normal, or below 60 beats per minute.

 A normal heart rate at rest is considered to be between 60-100 beats per minute. Keep in mind a low heart rate can be normal, depending on your activity and fitness level.

Blood pressure can be high despite a low heart rate. There are numerous causes of all these scenarios, but only some are serious and require medical intervention.

What does a low pulse rate indicate?

While a low pulse rate can be associated with high blood pressure, it can also be caused by other conditions.

Your body receives less oxygen when experiencing a low heart rate since less blood is pumped out.

It's also important to note that heart rate is situational. For example, a heart rate of 50 beats per minute may be too slow unless you are sleeping, when a low pulse is common because your body is more relaxed.

Moreover, a low pulse rate could indicate that you are more fit, especially for athletes who engage in high endurance training.

It is common for top athletes to have a condition called athlete’s heart.  There is an enlargement of the left ventricle in this condition, which improves oxygen delivery to the muscles. A low pulse rate can be common in this condition.

A low heart rate can be common among older people, as the signaling system of the heart ages and does not transmit the heartbeat impulses as efficiently as it should. In some cases, a permanent pacemaker may be required.

What is a dangerously low heart rate?

A normal resting heart rate is between 60 and 100 beats per minute (BPM), and if it is below 60 BPM, it is considered a low heart rate.

It is possible for a very fit person to have a resting heart rate that can be slower. But for most people, a heart rate below 50 BPM while awake, without any other obvious cause, is considered abnormal and should be investigated.

One of the main symptoms of a dangerously low heart rate is feeling like you are very dizzy or will pass out. This feeling is due to less blood reaching your vital organs, most notably the brain.

Without the right pulse rate or blood pressure, you may feel that you are about to faint or pass out, and you will likely feel fatigued.

If your heart rate is dangerously low, the heart can also pause for a few seconds and may cause you to faint. This can lead to serious injury, especially if it happens suddenly. 

Causes and risk factors of a low pulse rate

Here are some conditions that can cause a low pulse rate:

Sick sinus syndrome

This syndrome is also known as sinus node dysfunction (SND) and primarily affects the sinoatrial node, which is the area in the top of the heart where the heartbeat impulse originates. The condition is more common in older people.

With this condition, your pulse rate will abnormally slow down and cause lightheadedness and dizziness because there is not enough blood and oxygen circulating to meet your body’s needs.

Atrioventricular blockage

Low heart pulse rate can be caused if the heart's signals don't move correctly from the atria (upper chambers) to the ventricles (lower chamber). If this happens, the condition is called an atrioventricular block.

There are different versions of this condition, which can be detected by an EKG tracing or further cardiac testing to help pinpoint the area of dysfunction.

In some cases, a permanent pacemaker may be needed if no reversible cause is found.  

Metabolic problems

Some metabolic issues can result in a lower heart pulse rate. The most common is hypothyroidism, which occurs when the thyroid gland fails to release enough hormones. The condition can affect the health of blood vessels and the metabolism level, consequently slowing down the heart pulse rate.

About 5% of Americans have hypothyroidism,¹ making it very common among otherwise healthy individuals.

Other metabolic conditions that can lead to low heart rate include:

  • Hypothermia, which occurs when the body temperature becomes too low

  • Hypokalaemia, which happens when your potassium levels are too low

  • Hyperkalaemia, a condition that occurs when your potassium levels are too high

  • Acidosis, a condition where there is too much acid in bodily fluids

Heart medication

Some high blood pressure and heart disease medications can cause a lower heart pulse rate.

Sometimes doctors prescribe calcium channel blockers or beta-blockers for high blood pressure,  but these can also slow your heart pulse rate.

Contact your doctor if you have started taking new medication and experience lower heart rate symptoms.

Oxygen deprivation  

Oxygen deprivation, also known as hypoxia, is the term health practitioners use to describe a situation where the tissues of the body don’t get sufficient oxygen.

It is usually a medical emergency and mostly happens when you have experienced a severe asthma attack or choking episode.

When a person experiences a low heart rate due to oxygen deprivation, it is essential that they first address the underlying cause, such as asthma.

Measuring your heart rate

To avoid complications that arise due to low heart rate, you could regularly check your pulse rate on your own without having to visit a healthcare practitioner.

If you want to measure your heart rate accurately, you should measure the pulse when sitting or lying down. You should also ensure that you are completely calm and relaxed to avoid incorrect readings.

You can get your pulse reading from different body locations, most commonly at your wrist (radial pulse) and the side of the neck (carotid pulse).

When taking your heart rate, use two fingers to trace the pulse. Since it has a pulse of its own, do not use your thumb as it's likely to cause inaccurate results. Once you locate the pulse, press very gently and carefully count the number of beats you feel for 60 seconds.

You could set a stopwatch or use your phone to get a more accurate time count. If the heartbeat count is below 60 beats per minute, you have bradycardia. 

It is important to note that children and young people have a faster heart rate than adults. The average pulse rate for a baby is about 140 beats per minute, whereas teenagers and older children should have a standard resting heart rate of about 70 beats per minute.

When should I go to the ER for a low heart rate?

Low heart rate (bradycardia) can be a serious problem, especially if the heart rate is very low and cannot pump oxygen-rich blood to vital organs.

Bradycardia may be caused by various issues such as inflammation of heart tissue (myocarditis), aging, underactive thyroid gland (hypothyroidism), an imbalance of chemicals in the blood, inflammatory disease, and certain medications.

Be on the lookout for the following symptoms associated with a lowered heart rate:

  • Lack of energy

  • Low stamina

  • Dizziness

  • Weakness

  • Chest pains

  • Confusion/memory problems

  • Heart palpitations or flutters

  • Passing out or feeling like you will pass out

Treatment options for high blood pressure and low heart rate

You should monitor high blood pressure and low heart rate closely. However, in instances where you feel dizzy and tired, consider talking to your doctor for advice on correcting the condition.

Your doctor will conduct a physical exam and look at your medical history record to check if you have other underlying conditions. They will likely order testing, including an EKG tracing of the heart and blood work.

If you experience low heart rates irregularly, you might need to wear an event monitor, which allows your healthcare provider to observe your heart for extended periods without you having to be at the hospital.

There are other diagnostic tests, such as an echocardiogram, which is an ultrasound of the heart that allows for evaluation of the heart's structure.

Other tests that give more information about the heart include an exercise stress test and tilt table test. The exercise stress test records the heart rate before, during, and after exercise to look for abnormalities. It also helps assess adequate blood flow through the heart.

The tilt table test helps determine how changes in position can affect the heart rate and blood pressure to help determine the cause of the symptoms.

When it comes to treatment, it will vary from one person to the next and depend on the type, severity, and cause of high blood pressure and low heart rate. In some cases, your current medication may be contributing to your low heart rate.

For example,  if you are taking beta-blockers or calcium channel blockers, your medication may need to be changed to a different group of blood pressure-lowering medicines that do not affect the heart rate.

In a hospital setting, a recommended medication that helps temporarily raise low heart rate is atropine, which is administered through an intravenous (IV) route.

In cases of a severely low heart rate that does not respond to medication, there may be the need to implant a permanent pacemaker.

The lowdown

High blood pressure thickens the heart muscles making it difficult to conduct electrical impulses through the thick tissue. Your heart may not beat as fast when this happens, and your pulse will slow down.

Some of the symptoms of this condition include fatigue, shortness of breath, and, in some extreme conditions, severe chest pains, loss of consciousness, confusion, memory problems, and low stamina.

It's also vital to note that a low pulse isn't always an indication of a failing heart or high blood pressure. For example, athletes engaging in high-intensity training routines will generally have a low heart pulse. There are many other causes of a low heart rate that your physician can further evaluate.

Finally, it's important to know when to visit the ER while having a low pulse. If you have fainted or experienced heart palpitations and flutters, you should visit the ER for more urgent evaluation.

Speak to your doctor about the condition and let them guide you further on managing it effectively.

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