Brief Answer:
Initially five step approach is necessary

Detailed Answer:
Dear
Thanks for contacting with your health concern and following is the recommended guidelines:

A. Since at present there seems not to be any serious or significant heart pathology thus at present we have to control or modify the risk factors associated with high blood pressure which requires five step approach to the problem:

1. Exercise:
a. Brisk walk for 45 minutes every day, at least 5 days a week. Walking is the best aerobic exercise.
b. Yogasanas: theae should be practised and learned under guidance of an expert, and also after discussing with your physician as to which are permitted .
c. Pranayama: simplest is Deep breathing

PS. If you do not have any expert guidance, walking is the best and safest exercise.

2. Stress Management
. Meditation for 15 minutes everyday.
. Learn to live with a relaxed mind and think positive about your health and life.

3. Low fat diet
. Avoid : alcohol,caffeine,tobacco, butter, ghee, cheese,unskimmed milk, whole egg, deep fried food.

Take: soups,plenty of salads,raw sprouted pulses,more of bhajis prepared with minimum or no oil, curd of skimmed milk, pulses and legumes,roti or phulka without oil,onion, garlic,soya bean, apple, fruits with edible cover should be eaten with covers.

4. Elimination of known risk factors
. Smoking: both active and passive should be stopped and avoided.
. Weight reduction as per body mass index (B.M.I.)
. Maintain normal blood sugar level.
. Avoid mental strains through relaxation and if possible, change of job.

5. Drugs
. Take the anti hypertensive medicine as prescribed and other medicine of preventive importance is Anti oxidant, which you can order (at your discretion) directly from me, since it is purely consisting of anti oxidants thus will be very beneficial to you.

Dr. Munish
Consultant & Physician
Naimittika

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Brief Answer:
Consider Remodelling drugs and Lifestyle changes

Detailed Answer:
Dear
Thanks for reverting back.

1. Since left side of heart is attributed with pumping of the blood to whole body thus wall of left side is more thick than right side, and since left side has to pump blood against resistance thus keep your blood pressure under control since hypertension lately will cause pressure overload on heart and increase left ventricular mass, thus will have backward effect on the Lungs ( breathlessness) so adopt a healthy life style( as discussed earlier) and be under regular supervision/follow up of Cardiologist.

2. Talk with your doctor regarding use of ACE Inhibitors (Ramipril,Enalapril) which have the ability of Remodelling the ventricular mass.

Dr. Munish
Naimittika

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Brief Answer:
current approach is to use them as alternatives

Detailed Answer:
Dear
Thanks for reverting back.

1. There is a wide range of Anti hypertensive drugs available today and the choice will depend upon:

a. The tolerance of the patient to the drug
b. Individual choice of the Doctor
c. The cost of the therapy.

PS. In your case, (b) is the current option, and let me tell you that here at my clinic I usually prefer ACE inhibitor initially ( time tested) and if tolerance or response is not adequate only then shift the patient to fixed dose combination

2. Under no circumstances you should stop or change the drug without first consulting your attending physician.

Dr. Munish
Naimittika

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