It is rare for a person to experience high blood pressure and a low heart rate. Potential causes include Cushing’s reflex and heart conduction disorders.

In this article, we look at the possible causes of high blood pressure with a low pulse — these are the Cushing reflex and problems with heart conduction.

That follows an overview of blood pressure and pulse rates and what they should normally measure.

We also discuss when a person should seek medical attention.

Inside doctor's office with basic equipment on the wall.Share on Pinterest
Roberto Machado Noa/LightRocket via Getty Images

A person’s pulse rate is how many times the heart beats per minute.

Typically, a person’s resting heart rate will fall between 60 and 100 beats per minute (bpm). However, a heart rate lower than this range does not always signify a medical problem. Particularly athletic people may have rates as low as 40 bpm without adverse effects.

The medical term for a low heart rate is bradycardia.

Blood pressure measures the force of blood inside the blood vessels. High blood pressure can overload the circulatory system, increasing the risk of heart attack and stroke.

Most doctors consider high blood pressure as greater than 130/80 millimeters of mercury (mm Hg).

Severely high blood pressure is greater than 170/100 mm Hg.

Several health conditions and outside factors can cause high blood pressure, a low pulse, or both.

Cushing reflex

The Cushing reflex is a rare occurrence that causes a low pulse and high blood pressure.

The reflex results from the body’s response to increased intracranial pressure. Intracranial pressure is a blood pressure measurement in the brain.

The Cushing reflex is one of the body’s ways to try to keep pressure from getting too high in the skull. It signals receptors in the heart to slow the heart rate down to lower the intracranial pressure.

Severe medical conditions usually activate the Cushing reflex. These conditions include:

The Cushing reflex is an emergency. Once doctors recognize this condition, their goal is to treat the cause and reduce the intracranial pressure. If the pressure gets too high, it can permanently damage the brain. A person can die from excessively high intracranial pressure.

Problems with heart conduction

A low pulse rate can sometimes indicate a problem with the heart’s electrical conduction pathway.

The heart has an electrical system that travels in a distinct pattern to make the heart beat with a regular rhythm. If there is damage, scarring, or overstretching of the heart, the electrical system may not work as effectively. This can cause a low pulse rate.

Chronic high blood pressure can contribute to damage to the electrical system that, in turn, leads to a low pulse rate. Other causes of damage include smoking, a history of heavy drug or alcohol use, or aging of the heart.

A person should seek immediate medical attention if they have the following symptoms along with a low pulse and high blood pressure:

  • dizziness or lightheadedness
  • feeling faint or fainting
  • shortness of breath
  • chest pains

These symptoms may indicate that a person requires a hospital stay and possibly a pacemaker to treat whatever is causing their underlying heart problem.

High blood pressure and a low pulse rate is a rare occurrence. People are more likely to have high blood pressure alone unless they take medications that may affect their pulse rate.

Rarely, an increase in intracranial pressure can induce the Cushing reflex with a low pulse rate and high blood pressure.