[mysterypie]

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up[1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, etc, but nevertheless shorten your lifespan in other ways because of a higher heart rate?

[1] I've verified this for myself with careful record keeping over long periods of starting/stopping different BP meds, but I'm not entirely sure it's true for everyone.

[brandonb]

This sounds like reflex tachycardia -- your body wants to ensure blood is flowing to all the right places, so it raises heart rate to partially compensate for blood pressure falling. Reflex tachycardia can be a normal response to certain types of blood pressure medications, like vasodilators or diuretics. Beta blockers are a different common type of blood pressure medication that attempt to lower both blood pressure and heart rate simultaneously.

If the increase in heart rate is large (>30bpm), especially when going from laying to standing, it could be a sign of underlying dysautonomia or POTS. If you experience symptoms (dizziness, fatigue, fainting, etc) it's worth getting evaluated. We (the OP) do offer medical care for POTS here: https://empirical.health/pots

As for the relationship between low heart rate and longer life spans, it's not necessarily causal -- a lower heart rate is often a sign of a stronger cardiac muscle (each beat pumps more blood, so fewer beats per minute are required to pump the same volume of blood). So I'd suspect much of the relationship here is driven by these confounding variables!

[AnonC]

I won’t be a user of your service, but wanted to share a bit of feedback on the page you shared. On that page, I didn’t see any definition for POTS (though I know what it is or if I were someone else, I could’ve searched online). The page mentions a CHOP protocol without a link or explanation about what it is. I think the page could do better with some simple explanations or at least a guidance on symptoms and what you offer. Currently it seems like it’s optimized to be linked for anyone searching for POTS, which probably assume a lot more than what most people may be aware of.

[brandonb]

You're absolutely right. This page was originally written for people searching for POTS, so we assumed some context. I've updated the page to link to pages we've written on POTS diagnosis and the CHOP protocol, so that it stands alone a bit more.

[mysterypie]

Let me second your comment. That webpage really needs to define POTS and give a brief explanation. It's written as if everyone knows what it is. I've never encountered the term Postural Orthostatic Tachycardia Syndrome until now.

[brandonb]

Thanks! Mentioned above -- I updated the page to link to dedicated articles on each of these.

[eig]

It’s pretty normal for heart rate to increase with a drop in blood pressure. It’s part of a normal reflex called the baroreceptor reflex that your body evolved to keep you alive.

To answer your question, there have been an abundance of epidemiological studies showing that the drop in blood pressure is worth the slightly increased heart rate (assuming you’ve been diagnosed with hypertension). The main benefit is the drop in stroke risk, atherosclerosis, and kidney damage, even despite the fact that your heart has to beat faster.

[CookieCrisp]

My understanding of the heart rate correlation to lifespan between different species is that it is “within a couple levels of magnitude” and that an increase of 10% in a human’s rate does not correlate at all to a 10% decrease in lifespan

[smeeth]

I'm not a doctor, but my understanding is that lower blood pressure can indeed lead to a higher heart rate under certain circumstances. For instance, people taking minoxidil for hair loss can experience lower blood pressure, which leads to higher heart rates and increased left ventricle thickness as a side effect.

My suspicion is that this happens because the heart is trying to maintain a constant oxygen supply to the muscles. However, if blood pressure is lowered by improving factors like arterial flexibility, stroke volume (amount of blood per heartbeat), muscle oxygen efficiency, or oxygen content in the blood, the heart wouldn't need to pump faster.

[AStonesThrow]

It's the futility of trying to make two arbitrary numbers go down and covering up a mere symptom.

Hypertension is correlated with a lot of issues, and it's easy to measure.

It's also easy to keep formulating novel chemicals, so keep complaining about side effects, and your physician will be happy to keep spinning the Formulary Roulette Wheel.

[naveen99]

It’s complicated. You need blood pressure to live…

Too low heart rate can also be a problem.

talk to your cardiologist about your specifics.

At the population level, the guidelines have backed off over the last 20 years. What’s normal now used to be called high blood pressure.

[AnonC]

> Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans).

I’m not a doctor, but I don’t think this covers all cases. If someone has some kind of heart disease, they could have a lower resting heart rate and probably need medical attention and care. It may not imply that they’re going to live longer.

[Aerroon]

Have you mentioned this to your doctor? There are different types of blood pressure medications. Some will lower your heart rate.

Back when I took beta blockers they reduced my heart rate from 65-70 to 45-55.