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Over weight with high blood pressure. On diet food. What could be the reason?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
I am 37 yr old man. My weight is 98 kg & height is 180 cm. I am on a controlled diet (no salt meal in the evening, no processed food, no rice) & regular excercise for 2 months now and lost actually 5 kg in last one month. Recently checked my BP & was shocked to see it as it was quite high 150/90. I am monitoring it for las 7 days & its not coming down. What to do?
Posted Fri, 29 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 5 hours later
Thank you for the query.

I understand that you are 37 year old overweight male with high blood pressure with a family history of hypertension.

150/90 mmHg indicates that you are having Stage I hypertension. However, you need to ensure that the BP has been measured using proper techniques when you had been at complete rest for at least half an hour and at least half an hour free of any tea/coffee/other beverages. Since you are obese, a proper sized cuff should be used while measuring the BP. An undersized cuff might give wrong readings.

Having confirmed the presence of high blood pressure, you should get some basic evaluation done for other associated conditions like diabetes and abnormal cholesterol. Also, you need to get tested for any evidence of target organ damage. Target organs are heart, brain, kidney, eyes and blood vessels. Also, a risk evaluation for any other cardiovascular risk factors should be done.

The necessary tests and evaluation can be done by any trained MD physician or a cardiologist.

It is essential to understand that hypertension per se is nothing to be alarmed about. It is a risk factor that needs to be controlled. If the BP is kept under control, you are safe. But you cannot neglect it and risk serious problems later. High BP is a silent killer. You may not have any symptoms till permanent damage has been done.

In view of obesity, and a positive family history, it is probable that you will need medicines to control the BP. There are many choices available today that are safe and can be used lifelong at once daily/twice daily dosage. The exact drug will depend on the findings of clinical evaluation and investigations.

It is essential to take the drugs regularly and monitor the BP regularly. A target BP of 135/85mmHg can be achieved.

Also, lifestyle management is of utmost importance. A good salt restricted, low fat diet XXXXXXX in fruits and vegetables will help. Daily exercise (dynamic/aerobic exercises like walking, jogging, swimming, etc) will help. Do not do excessive weight lifting/weight-training exercises since they can increase the strain on your heart muscle. Stress management is essential. Yoga and other similar relaxation techniques can help. While it is not always possible to avoid stress in life, one can at least try to control how one reacts to it.

I hope this answers your query. Feel free to ask me for any further clarifications.
With regards,

Dr Raja Sekhar Varma, MD, DM
Consultant Interventional Cardiologist
Above answer was peer-reviewed by
Follow-up: Over weight with high blood pressure. On diet food. What could be the reason? 11 hours later
Hello Doctor,
Thanks for your reply. As you said, I need to get tested for target organ damage for heart, brain, kidney, eyes and blood vessels along with the basic evaluation like diabetes and cholesterol, what are the tests you recommend to get fair evaluation of the condition? How frequently these tests would be required?
Answered by Dr. Raja Sekhar Varma 12 hours later
Thank you for the reply.

Firstly, you need a detailed clinical evaluation by a qualified physician or cardiologist. This would include a detailed history and a complete physical examination. In addition, fundus examination of the eye by an ophthalmologist would be ideal.

The common basic tests include hemogram, Blood urea, serum creatinine, serum electrolytes, serum uric acid, hsCRP, fasting blood sugar, fasting lipid profile, thyroid profile (T3, T4, TSH), ECG, echocardiogram, treadmill test, routine examination and microscopy of urine. Depending on the results of the clinical evaluation and the initial test reports, further specific investigations may be necessary.

If the results are normal, these tests are usually repeated annually. However, there may be variations depending on physician preference and your individual need.

I hope this answers your query. I wish you all the best for a healthy and happy life.
With regards,
Dr RS Varma
Above answer was peer-reviewed by
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