High blood pressure cause high heart rate

Ask An Expert

Question:

My son, 20, is leaving for boot camp soon. He's developed a rapid heartbeat during his work outs and sudden spikes in blood pressure. He had an EKG and all was normal. They thought it was stress. What are the next steps?

Answer:

There are a number of heart rhythm abnormalities that can cause a sudden rapid heartbeat during exercise. A normal evaluation in the emergency room typically will not reveal the rhythm problem because the evaluation is done at rest. A more detailed evaluation that includes treadmill stress testing is usually needed to bring out the rhythm abnormality and capture it on ECG. An ultrasound of the heart, or an echocardiogram, is almost always considered in order to assess the health of the heart muscle and valves. This is done because if the heart function is mechanically normal, the heart rhythm abnormality is typically not life-threatening.

The sudden spikes in blood pressure is of concern, especially if the spikes are very high. Fluctuations in the systolic blood pressure to the 140-150 mmHg range can be seen with minimal exertion or anxiety, and is most likely normal. Spikes that reach into the 180-200 mmHg range, however, are more likely to be abnormal, and does raise concern for conditions such as pheochromocytoma. This is a rare adrenal gland tumor that indeed "leaks adrenaline" and causes surges of symptoms that usually include racing heart beat, excessive sweating, headaches, and very high spikes in blood pressure. This is evaluated by checking levels of adrenalin compounds in the blood and the urine. If an abnormal level of adrenalin compounds is detected, the tumor can be detected through a variety of scans including CT scanning.

There are a number of other conditions that can mimic pheochromocytoma that should also be looked for, such as abnormal drops in blood sugar (hypoglycemia), certain prescription drugs that can influence the body's ability to process adrenalin, over-the-counter drugs or supplements that have stimulants in them, or recreational drugs.

With either symptoms of sudden rapid heartbeat or high spikes in blood pressure during exercise, one should be evaluated by a primary care physician prior to a physically demanding program such as boot camp. There are some rhythm abnormalities that are dangerous, and excessive physical stress can be unsafe. Exercising with the diagnosis of pheochromocytoma would also be ill advised. Depending on the initial findings, a consultation from an endocrinologist, cardiologist, or an electrophysiologist could prove helpful.

Related Questions

Posted on November 2nd, 2017

Blood pressure and heart rate are two different measurements. While they are frequently measured at the same time in the doctor’s office, they are distinctly different factors in heart health.

Blood pressure is the force exerted against the artery walls when blood pumps through the body, usually measured with two numbers. The top number (systolic pressure) measures the pressure as the heart beats and moves blood into the arteries. The bottom number (diastolic pressure) measures the pressure as the heart relaxes between beats. A blood pressure reading of 120/80 is considered normal. 

Heart rate, also called pulse, is the number of times your heart beats per minute. Heart rate can change based on activity level, age, medication, and other factors throughout life. For most adults, a resting heart rate of 50 to 100 beats per minute is considered normal. People who exercise regularly often have lower resting heart rates. 

In some situations, such as periods of acute stress or danger, blood pressure and heart rate may both increase at the same time, but that’s not always the case. Your heart rate can increase without any change occurring in your blood pressure. As your heart beats faster, healthy blood vessels will expand in size to allow increased blood flow, which helps your blood pressure remain relatively stable. This is often true during exercise, when your heart rate can increase substantially but your blood pressure may only change slightly. 

Measuring heart rate alone is not an indicator of high or low blood pressure, although it can measure your cardiovascular activity and oxygen consumption. People with hypertension (high blood pressure), must regularly monitor their blood pressure and work closely with their physician to determine treatment options. Most physicians will continue to monitor both blood pressure and heart rate for all patients, since they indicate different factors of heart health. 

If you have questions or concerns about your blood pressure or heart rate, contact the Oklahoma Heart Hospital to schedule an appointment with one of our physicians.