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Lipid profile test done. Suggested atenolol. How to improve diastolic blood pressure?

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Answered by

Internal Medicine Specialist
Practicing since : 1996
Answered : 961 Questions
Hello Doctor,

My last few blood pressure readings are as follows:
31-Jan-13: 140/106 mm of Hg
07-Feb-13: 130/90 mm of Hg
14-Feb-13: 136/100 mm of Hg
07-Mar-13: 136/100 mm of Hg
14-Mar-13: 140/100 mm of Hg (first reading) & 130/100 mm of Hg (second reading)

Lipid profile done on 09-Mar-13 (total: 153 mg/dl, HDL: 28.6 mg/dl, LDL: 101.7 mg/dl, VLDL: 22.7 mg/dl). Please refer attached detailed test report on lipid profile.

Age: 31 yrs, Height: 181 cm, Weight: 84 kg, Pure vegetarian, Don’t Smoke, Don’t take any alcohol.

Doctor has suggested to take Atenolol 25 mg (1 per day) on 14 Mar 13. Should I start taking the suggested medication? Specifically, what can be done to improve my diastolic blood pressure? If possible, I would prefer to avoid it and improve things by some other means as I am just 31 yrs old and don’t want to take medicine for life long for BP.

I would like to know about my present heart condition and future risk as my blood pressure and cholesterol values are not ideal. Based on doctor’s advice, I have increased physical activity (brisk walking, yoga) and avoiding outside foods as much as possible from last one month. My aim is to reduce weight by 4 kg, avoid physical inactivity and take more fruits and vegetables.

Thanks in advance.

Posted Thu, 4 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Prasad Akole 31 minutes later
Welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

A well placed query with reports.
I saw your reports and findings. I can understand the anxiety of a young hypertensive.

You have mainly diastolic hypertension and a non-protective HDL and lipoprotein A levels. Rest lipids are acceptable. Your weight is little on the higher side. Lifestyle is not mentioned, but may play a role.

Young hypertension should be extensively evaluated before it is labeled as essential hypertension.

What are your symptoms or was it detected during a routine check?
Please describe any symptoms in great detail.
You have not mentioned if you have undergone any additional testing and a cardiologist’s opinion.

I would recommend a detailed physical examination, ECG, 2 D echo to document left ventricular hypertrophy (LVH), urine routine and microscopy, X-ray chest, ultrasound of the abdomen and kidneys, blood sugar fasting and PP, renal function tests, haemogram to begin with.

These are to rule out other causes like kidney related causes, diabetes, any tumour like pheochromocytoma and to know the degree of heart affection (mainly LVH) which helps future comparison.

You may take a prescription anxiolytic like alprazolam for few days. Take adequate rest, avoid stress and try regular activity, guided increase in aerobic activity, avoid spicy, junky food.
Use cardio-friendly cooking oils. Keep strict check on BP with a home –BP monitoring machine.
Try gradual weight control, not being obsessive about it.

Atenolol is a beta blocker used in hypertension. But it may cause sexual dysfunction like impotence in some. I would not prefer it in the young, if I can use other alternatives like ACEI (Angiotensin Converting Enzyme Inhibitors) or others which help diastolic BP and reduce myocardial muscle mass and remodeling.

I would recommend these measures as of now. Would add any more if I get any additional information from you.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries.
Take care and please keep me informed of your progress at
Good Luck! Thank you!!
Above answer was peer-reviewed by
Follow-up: Lipid profile test done. Suggested atenolol. How to improve diastolic blood pressure? 11 hours later
Hello Dr. XXXXXXX Akole,
Firstly, let me thank you for a very comprehensive reply and also for looking at the problem from being in my position.
I got to know about this high BP during a routine check up in my office but let me add even earlier during my pre-employment checkup I was told that my BP is on little higher side in another lab.
I have not done any other additional testing or met any other Cardiologist. The doctor who suggested Atenolol visits our office weekly and I guess the doctor is a general physician. Thanks for letting me know that it can cause sexual dysfunction like impotence in some. I don't want to take risk.
From last four to five years, my physical activity has been less as mine is a desk job and I didnt do any physical exercises or aerobics, which I have very recently tried to improve. Two years back there was a period which was little stressful for a period of about four months. Regarding diet, I will try to mention the something in general and it is not exactly the same. Mornings mostly its idly / dosa + coffee and in afternoon it could be some variety rice / rice + dal/ sambar / rasam + vegetable curry + papad and nights it is chapathi/upma/ poori / dosa + fruit + milk and I do have tea & snacks (sometimes) during evening.
Doctor for me to get all the tests done, it may take some time and can you please tell me a way to continue this communication after the test results are available?
Also, Please tell me the name of medicine [ ACEI (Angiotensin Converting Enzyme Inhibitors)] along with dosage which I can get pharmacy stores? or Should I say something to the doctor who visits our office weekly?

Thanks in advance.

Best Regards,
Answered by Dr. Prasad Akole 2 hours later

Thanks for the information.

Not all get problems with atenolol. You can tell your office doctor that you would like to be thoroughly evaluated before you can continue Atenolol. He can prescribe you the tests that I mentioned. You ‘got this info on the net’ would do.

ACEIs are started if there is no kidney dysfunction on testing.
You can continue Atenolol for a few days till tests are done, as sudden withdrawal should not be done. It is an excellent drug for the heart though. Show a cardiologist for opinion after you get these lab tests done and get physically evaluated by him. You can ask your doctor for a prescription for one (like Ramipril 2.5 mg once daily to start with) and then titrate to BP.

Let me know the reports as attachments at
on the same site by asking me a Direct Question (click ‘ask me a question’ button on my page).

As you are already inclined, shift to an active life and follow my advice in the earlier reply.
I am not authorized to prescribe you online but can definitely advise you the correct course to take.

Take a brief course of alprazolam upon prescription by your doctor. It helps ease the tension and helps reduce BP to some extent.

Hope, I answered your query.

Wish you good health.

Above answer was peer-reviewed by
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