Increased Blood Pressure since Pacemaker insertion

I have always had low blood pressure, always and proud of it around 105-110/80  I am fit and healthy.

While waiting for my pacemaker insertion my blood pressure is of great concern to my cardiologist and any doctor I see who all want to put me on BP medication which I do not want to is now between 140 - 165/90.

I have tried to find reference studies accounts but not much of use has appeared. The only thing is here that back in the early to mid 2000 some members stated that they had the same issues.

Can someone direct me to anything that may explain this increase triggered by a pacemaker insertion - I have a Boston Scientific...




high blood pressure

by new to pace.... - 2022-06-14 07:02:41

I heard it is called the "white coat sydrom" spelled wrong sorry.  when you see a white coat your blood pressure goes up.

new to pace

White Coat Syndrome

by Good Dog - 2022-06-14 07:46:20

I suppose that there could be multiple reasons why your BP went up. It is impossible for me to know what it might be. Frankly, I am surprised that your doc did not invesrigate further before suggesting med's. My wife has "white coat syndrome" and I've even experienced it when anxious about something at the doc's office. There is a simple solution. We bought an inexpensive BP monitor at the Drug Store so that we could monitor and log our BP at home periodically throughout the day. It paid for itself when we were able to determine that our BP's are relatively normal when in a relaxed setting. The opposite could also have been true if we did in-fact have a high BP problem. 

I am sorry I cannot be more helpful, but I think that this is at least one way to determine and/or rule-out white coat syndrome.

I wish you the best,


Increased blood pressure

by Gemita - 2022-06-14 08:47:04

Hello Zingbasil, 

You say your blood pressure started climbing at the time of your pacemaker implant procedure which I see was 2 yrs ago.  Maybe there was a lot more happening with your heart at that time too, like arrhythmias leading to your syncope, the reason for your pacemaker? 

During any trauma or illness, I can expect changes in both my blood pressure and heart rate which is often partly caused by my “over active” sympathetic nervous system jumping into action.  Once the perceived threat is over and I start healing and feeling less anxious, my blood pressure and heart rate usually normalise.  2 yrs on though, you should be well past the healing stage.

I have seen quite a few posts here regarding higher than normal blood pressure following pacemaker implant and asking why.  Some members have felt that it was due to suddenly being paced at a consistently higher heart rate, following years of bradycardia, or due to the trauma of having an implant, particularly in the early stages while our body is getting used to being paced.  Some have had limited success by lowering their (Base Rate) setting slightly.  However while a pacemaker can prevent a fall in our heart rate below our Base Rate setting, it cannot prevent an increase in heart rate say from an arrhythmia, nor can it control our blood pressure.  My blood pressure is very low but it can be volatile during heart rhythm disturbances, hitting extremely dangerous levels.  Is it possible that you have heart rhythm disturbances?  This could definitely adversely affect your blood pressure.  I see you have had an Aortic and Mitral Valve replacement in the past.  I presume these were successful and are causing no difficulties?  

High blood pressure is dangerous in whatever circumstances and I would follow your doctor’s advice and consider taking medication to keep your blood pressure stable and to keep you safe while you look for answers and/or lifestyle changes which might help to bring down your blood pressure naturally.

I attach a couple of Pacemaker Club links which you will need to copy and paste into your browser to open.  As you will see, many conditions can affect our blood pressure.  I think it is important that you go back to your doctors for advice on stubborn hypertension rather than trying to self diagnose the cause.  They may decide to order blood pressure/heart rhythm external monitoring as well as look more closely at your pacemaker downloads.  Good luck and stay well,


by Tracey_E - 2022-06-14 09:05:25

White coat syndrome is real. My numbers are always a lot higher at the doctor's office than at home. When I was borderline, my doctor had me track at home for a month. My numbers were definitely better at home but still not low enough to make my doctor happy so I'm now on meds. I really hate meds. Really really really hate them. But I'd hate a stroke more, so I suck it up and take them.

It doesn't have to be forever, sometimes daily tracking can help us figure out what triggers an increase. 

The cardiologist will often want our numbers lower than the GP will be happy with. 

BP raised by PM - it can be real

by crustyg - 2022-06-14 10:56:00

Take a large, athletic heart that usually beats at 40-50BPM, and then suddenly start driving it at 60-160BPM and it wouldn't be a surprise to see an increase in mean BP.

For patients who have been in an atrial tachy-arrhythmia for some time there is an additional factor, that ANP production/release is impaired by the rhythm disorder.  Normally, if I drive your HR up (so more blood per minute into the aorta) then part of your body's natural regulation mechanism is to release ANP which makes the kidneys dump sodium and water, reducing the amount of filling of the heart for each beat => less cardiac output, over time, lower BP.

However, 105/80 while good, it isn't that wonderful: 105/60 would be a lot nicer/better, so you may have been nearer the cusp of increased BP than you like to think.


by Julros - 2022-06-14 14:53:07

I think CrustyG has a good explanation especially for you athletic folks. And yes, meds are preferable to stroke, as well as kidney and blood vessel damage. The one thing I would add is that normal aging causes our blood vessels to be less elastic/more resistant to stretch leading to higher pressure. I take wee doses of lisinopril and metoprolol and have no ill effects.

preferable to stroke

by AgentX86 - 2022-06-15 22:02:26

Remember, death isn't the worst outcome of a stroke!

You know you're wired when...

You make store alarms beep.

Member Quotes

I'm 44, active and have had my device for two years. I love it as I can run again and enjoy working out without feeling like I'm an old man.