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Suggest Treatment For Uncontrolled Hypertension

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Posted on Mon, 16 Nov 2015
Question: I am 52yrs old. would have had uncontrolled hypertension. One of my medication is atenonol 50mg. Was told i should stop the atenonol for at least 5 days before a stress echo as this will mask the test to determine the condition of the heart. Is this so?
If the echogram indicates the contraction of the heart was ok but the heart looks stiff what is the prognosis of this?
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that the stress test is used to investigate the presence of a possible cardiac ischemia, by studying any regional myocardial contraction abnormality, which may not be visible during the resting echocardiogram.

So atenolol which posses negative inotropic properties (may lower myocardial contraction strength), may blunt the heart muscle response during exertion, masking that way the real heart reaction during stress test.

So you should follow the advice to stop atenolol before performing that cardiac test (as advised by the procedure protocol).

Regarding a possible conclusion of the test, which may be a myocardial stiffness response, without any regional contraction abnormalities, this could be due to impaired diastolic cardiac function, which may be related to left ventricular hypertrophy (such in the case of a long standing uncontrolled hypertension), or to any other cardiomyopathy affecting myocardial relaxation and the diastolic phase process.

Depending on the reason of the myocardial stiffness, the prognosis would vary.

For example, in the case of uncontrolled hypertension, if blood pressure values are kept under control hereinafter, then this pathological process would be stopped and the prognosis would be much better, similar to the normal individuals.

In case of other etiological causes, the prognosis would depend by the specific profile involved in the process (its irreversibility and severity).

For giving a better professional opinion on the matter I would recommend you to upload your stress echo report when it will be performed.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

You can ask me directly at any time at the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Best wishes!

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9539 Questions

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Suggest Treatment For Uncontrolled Hypertension

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would like to explain that the stress test is used to investigate the presence of a possible cardiac ischemia, by studying any regional myocardial contraction abnormality, which may not be visible during the resting echocardiogram. So atenolol which posses negative inotropic properties (may lower myocardial contraction strength), may blunt the heart muscle response during exertion, masking that way the real heart reaction during stress test. So you should follow the advice to stop atenolol before performing that cardiac test (as advised by the procedure protocol). Regarding a possible conclusion of the test, which may be a myocardial stiffness response, without any regional contraction abnormalities, this could be due to impaired diastolic cardiac function, which may be related to left ventricular hypertrophy (such in the case of a long standing uncontrolled hypertension), or to any other cardiomyopathy affecting myocardial relaxation and the diastolic phase process. Depending on the reason of the myocardial stiffness, the prognosis would vary. For example, in the case of uncontrolled hypertension, if blood pressure values are kept under control hereinafter, then this pathological process would be stopped and the prognosis would be much better, similar to the normal individuals. In case of other etiological causes, the prognosis would depend by the specific profile involved in the process (its irreversibility and severity). For giving a better professional opinion on the matter I would recommend you to upload your stress echo report when it will be performed. Hope to have been helpful! Feel free to ask any other questions, whenever you need! You can ask me directly at any time at the link below: http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765 Best wishes! Dr. Iliri