Which BP meds do not affect heart rate?

[Zippy Head]

We argue about this all the time on the med floor, no matter what the drug book says, which I think is a little vague on the matter. So to the Cardiac nurses- which BP meds lower the BP without affecting heart rate?

[casi, ASN, RN]

I would think Ace Inhibitors.

[GRUNGE]

As far as the drug it self only beta blockers will slow the heart rate. However any time you decrease the work load of the heart it will have an effect on the hr. Ace, arb, and diuretics have no direct effect on the heart rate

[Richard_Head]

I think a better way to phrase the question would be "what BP meds have a direct effect on heart rate?" Beta blockers that have a greater % of beta 1 affinity, non-dihydropiridine calcium channel blockers. Any med affecting BP can indirectly effect HR via carotid and aortic body feedback mechanisms (think compensatory tachycardia to maintain CO) and some meds such as hydralazine are actually labeled as causing a reflex tachycardia.

[HeartRN2008]

Agreed with Richard Head.

But to be simple, if what you're presenting is a scenario in which Pt. X has a rocketing BP but is bradycardic, yes, I have many a time used ACE's, particularly IV but PO as well, and had them work wonderfully for that type of situation. :)

[MassED, BSN, RN]

As far as the drug it self only beta blockers will slow the heart rate. However any time you decrease the work load of the heart it will have an effect on the hr. Ace, arb, and diuretics have no direct effect on the heart rate

"it will have an effect on the hr."

and the BP

[07302003, ASN, RN]

In my experience, hydralzine is HR sparing, while lowering BP.

[Richard_Head]

read the data on it: known side effect is reflex tachycardia from a baroreceptor mediated response. from the not so scholarly wikipedia:

clinical use

hydralazine is not used as a primary drug for treating hypertension because it elicits a reflex [color=#0645ad]sympathetic stimulation of the heart (the [color=#0645ad]baroreceptor reflex). the sympathetic stimulation may increase heart rate and [color=#0645ad]cardiac output, and may cause [color=#0645ad]angina pectoris or [color=#0645ad]myocardial infarction.[color=#0645ad][1] hydralazine may also increase [color=#0645ad]plasma [color=#0645ad]renin concentration, resulting in fluid retention. in order to prevent these undesirable side-effects, hydralazine is usually prescribed in combination with a beta-blocker (e.g., [color=#0645ad]propranolol) and a [color=#0645ad]diuretic.[color=#0645ad][1]