rapid heart rate/Toprol?

[Brainy09]

I love this site! I hope you can please help me! This may be long, so I apologize in advance, I am just so confused. I am a 36 years old female, 117 pounds 5' 7", vegetarian, smoke 1 pack of cigarettes a day and stopped caffeine for a month and a half thus far. I always have a high heart rate 90-100 at rest, with low blood pressure, my cardiologist says that is just how I am. I recently had chest pains, my heart rate was 130, I went to the ER for the pains and then to my cardiologist for a follow up echo cardiogram. Everything came out fine, (blood work was good) most likely a panic attack. I have also been diagnosed with fibromyalgia. My primary physician just prescribed me  25mg of Toprol and I am currently taking 1.5 mg of Xanax per day for the panic attacks. I am unsure if I should start the Toprol seeing that I have low BP. I am afraid that it will lower my already low BP, but my heart rate is always so fast that I can sometimes hear and feel it pounding. I wake up during the night and in the morning with my heart racing which in turn triggers a panic attack. I do not want to start a medication that can do harm and that I will have to be taking for the rest of my life. Should I take the Troprol or is my heart just made this way? Your opinion is so appreciated!!

[Jerry_NJ]

I'd say follow you primary care doctor's recommendation and take the 25 mg (SR?) Toprol.  That is a fairly low dose and will like have only a small and (I think) temporary lowering of your BP.  I have taken up to 200 mg a day of Metoprolol (generic) and I have a history of normal BP. This high dose made my BP drop to the point of being a slight problem, some dizziness when I made sudden changes in my activity, like standing up quickly from a sitting position.  That has passed, I don't recall the last time I was dizzy.

I understand some people have higher HR than the athletic 60 bpm at rest, and if one has low BP, it seems reasonable that the HR may have to be higher to get the oxygen needed out to the muscles.   I'm not sure on this point, but I think I've read it somewhere before.  

[Brainy09]

Thank you so much Jerry for your response! I think I may go to my cardiologist for a second opinion on the medication. I am just so nervous to take it seeing that I have had a fast heart rate with low BP all of my life...