hello, First, high bp is most probably a age related change in you because pacemaker adjustment will not lead to this. Secondly, high pulse rate is most probably a part of sick sinus syndrome, because these patients have bradycardia and tachycardia. We need one ecg to confirm confirm the type of high heart rate. If Normal we may need holter as well. Also, you should get one hemoglobin level and thyroid test done. You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. If bp remains high more than 140/90 then you should be started on bp medicine. Regular exercises like brisk walking, jogging according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn t abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..