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Have high blood pressure. All medical test normal. What should I do to reduce BP to normal?

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I am a 30 year old male with no known health conditions.

I've been repeatedly told that my blood pressure is on the higher side (highest reported 140/92). My wife is a dental surgeon, and she occasionally measures my blood pressure to see if everything is OK.

However, it has always been floating around the range of 140/90 and I visited a cardiologist to see if anything is wrong. A chest x-ray, echo cardiography, ECG, and stress test was conducted. The doctor reviewed the test results and declared that everything was fine. He analysed my breathing and tested my heartbeat, etc., with stethoscope and said that it was all good too. I am wondering if there's something that's going unnoticed or undiagnosed.

I am atheletic, and can endure on a treadmill for 40 minutes at 9KPH (burn about 400 KCal) when I do cardio vascular training, and I also do reasonable amount of resistance training with free weights. I've been working out for over 10 years, I do not smoke, drink, or have any other habits that may affect my health adversely.

The only "bad" thing I do is, I eat XXXXXXX fried foods like chips and crackers with my lunch regularly.

I understand that high blood pressure can contribute to a number of unwanted diseases, and I am wanting to reduce my blood pressure to normal. Are there any tests that are recommended, or is there something that I can do?

Posted Wed, 27 Feb 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 5 hours later
Hi friend,
Welcome to Health Care Magic

Systolic pressure (upper figure) of 140 is in the upper limit of normal range.
90 is the upper limit for the diastolic (lower figure).
The “normal” pressure is an average value / it is a continuous range / derived from population studies - beyond 115 or 120, statistically, it has direct relation to longevity and has long term implications. As a matter of fact, till recently, 130/80 was defined as upper limit and 140/90 was called pre-Hypertension (now it is called high normal).

It is unlikely to be from anxiety from the doctor -so called ‘white coat’ hypertension. In your case, the white coat is your own spouse and if anything, the coat must be reassuring.

Your personal history too is exemplary – no avoidable risk factors. You are a good son and a great husband! Congratulations! Keep it up.
You have not said of family history...

It is reassuring to see that all the investigations are normal. A normal ECHOcardiography practically excludes anatomical (structural) problems.

A normal stress ECG practically excludes functional problems of blood flow.
You have great endurance and excellent exercise capacity – beyond the reach of many ordinary men!

Breathing tests confirm normal lung function

In other words, YOUR HEART IS NORMAL (structurally and functionally)

Your food habits do not go with your cautious approach. Up to now, it could be excused because of age and no health problem till date. NOW IS THE TIME TO CHANGE – fried foods have high fat / chips have high salt content. Try to see a dietician – after the lab tests.

You should test your RENAL function (urea, creatinine, electrolytes) - could cause or be a consequence of pressure.
You must see LIPID profile (Cholesterol- LDL & HDL, Triglyceride on 14 hour fasting) – it has no direct relation to pressure, but is additional risk factor.

As you say, high blood pressure is often silent and has several consequences – Heart, Kidney, Eyes and Brain are called the target organs. It usually takes years of neglect. But your pressure is borderline / no problems so far. NOTHING TO WORRY.

It is very difficult to find the cause of elevated pressure, in a given individual. Approximately 95% are so called “ Essential Hypertension” meaning the cause is unknown - most likely inherited; might have skipped generations. Only in about 5% of cases, the cause can found. But it is cumbersome, not cost effective and frustrating. SO YOU NEED NOT DO ANYTHING except the lab tests.

Whatever may be the cause, it can be and should be treated.
There are several classes of drugs / several drugs in each class / rather safe and effective.
Generally, Angiotensin Receptor Blockers (ARB – example Olmesartan) is one of the first line drugs. Start with a small dose / check after a fortnight / step up, if necessary / till BP is controlled – less than 130 or maximum dose is reached.
In case of need, later on, a Calcium Channel Blocker (CCB – example Clinidipine) or a Diuretic (example – Chlorthalidone or HC-Thiazide) can be added.

Relax / You seem to be intelligent / you just need a little more care now /

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Have high blood pressure. All medical test normal. What should I do to reduce BP to normal? 2 days later
Dear doctor,

Thank you very much for your answer.

I'll do the renal function and lipid profile tests as suggested and will have the outcome analysed.

Again, thanks for your time and efforts.
Answered by Dr. Anantharamakrishnan 16 minutes later

Wish you all the best
Have a great day / great life

Above answer was peer-reviewed by
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