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PACs, Arterial Hypertension, Anxiety (Male, 22)

Hello and thank you for having this forum available for us.

First off, I'm a male 22 years old. I have arterial hypertension for years already (130/80 earlier in childhood and recently 140/90 are the average figures BEFORE using BB for the treatment). I also have elevated levels of triglycerides that I'm compensating with high quality Omega 3s and once went for medicine to lower them for a bit. I believe it's all because of my genes that is, unfortunately, causing this all.

For almost a year now I'm on a beta blocker (Nebilet - Nebivolol) for my hypertension and this medicine is definitely working for this. I have minimized my average numbers to 125-135/70-80 and I'm glad to see I'm controlling my BP, at least for slight figures. Other than that, I have had EKG, stress EKG and two ultra-sounds for the heart and all came normal at that time. To add, this is all because my father passed in his early 40s because of untreated heart disease. So I rather pay attention to all that instead of ignoring my genes and family history.

Here comes now my question, I'm sorry for the long introduction though. Recently I have noticed that when resting (and only when at resting) my heart rate is having premature beats (I believe these are those PACs). It's like Beat-Beat, then pause, then Beat-Beat. It can stay for this like for minutes and only will be back to normal when I stand up or start doing something physical. The pause between Beat-Beat is like 0.5 seconds and between these "double beats" - like 1.0-1.2 seconds. I'm concerned about whether this rhythm won't result into any other not-benign arrhythmia.

Like most of us, I've read tons of articles regarding this matter. Most guidelines say they are benign, some say they might be a sign of underlying heart disease. But then again, those PACs were not cought on EKG at that time and when I tell them about this, they usually say not to count my pulse, not to worry about them and think about them. They also connect it to anxiety, that I cannot disagree. I get anxious about this feeling sometimes and it just triggers more those sensations of PACs involved.

An professional comment on this question would be very much appreciated. Maybe I have to give a try to some potassium, calcium and magnesium supplements to see what happens. Other than that heart rate, I have no other symptoms. But I'm worried that later they can involve some symptom.

Thank you once again.
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replied July 8th, 2012
Atrial premature beats are generally quite benign and we treat them only rarely. I have seen a few patients in which slow heart rates seem to be associated with atrial premature beats, and, of course, beta blocker drugs do slow the heart rate.
Blood pressures of 140/90 mm Hg are borderline, and you may be the kind of person who would best take blood pressures at home (and record the results for your doctor).
Based on your history, it certainly makes sense to pay attention to the known risk factors for coronary heart disease.
Please be advised that I am unable to diagnose medical conditions online.

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