### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been on Metropolol for 4 weeks, prescribed for palpitations (400 in 24 hrs. per monitor) 50 mg. Also I have white coat syndrome, sometimes pressure rises, been under a great deal of stress, mostly apprehension re: heart tests, etc. Cardiologist says metropolol is good for bp also. I have a monitor, pressure is lower at home, only rises when I maybe active 150/62, pulse in the 70 s and has been as low as 112/60. Still I take readings to the Dr. to let him see that it really is when I am under stress. 50mg made me tired ( Cardio said it would be sluggish), I do feel calmer, had to do 25 twice a day. Still I can fall asleep sitting watching TV and that is not me. I think I could try 25 per day, that is how I started out, but my pressure in theDr. office was 162/63 so he changed it to 50. Now I notice my pressure is higher anywhere from 112 to 175 with the bottom # in the 70 s and my pulse in the 60 s. My Dr. didn t mention the fact that it was compared to at home readings, also because I am calmer in office reading was only 136/62 He thought all the numbers were good, but yet they were higher than before when I took them at home. I don t get it, I thought BP meds reduced your pressure.

### output:

With respect to palpitation, that is the sensation not the extra beats. The extra beats may not be harmful or even require treatment. If you have found no underlying heart disease or dangerous rhythm, the primary concern is to relieve your symptoms and anxiety. Finding nothing dangerous does not necessarily mean that heart rhythm is not the source of what you feel but knowing that it's not dangerous is often treatment enough. The best way to interpret your blood pressure is to take only recording done on schedule. Single measures should not prompt concern, particularly no those done under stress. Record your blood pressure on a schedule every day. It should be taken seated after a 10-15 min period of relaxation. A two-week average is what you use to make decisions about the need to take a medicine and its effect.