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Hi There. 40 Year Old Male Here, Overweight But Working

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Posted on Sat, 11 Jul 2020
Question: Hi there. 40 year old male here, overweight but working out on average 6-7 days a week, trying to eat healthy, etc. I'm trying to stave off high blood pressure (mine fluctuates to <120/<80 occasionally to more common a little above 120/80, but generally not over 140/90 and usually quite a bit below that.

I have a bit of anxiety, which might be contributing to this, but I swear I can very mildly see the pulse at the sides of my neck if I look closely in the mirror. It is NOT obvious or prominent, and it may even come down to feeling my heartbeat in general, as I sometimes am unfortunately aware of it. If anything it's just a very slight movement; breathing actually makes it move more. I just noticed the other day what I thought to be my pulse there, and I'm wondering if it's normal to ever visually detect it along the sides of the neck? It's very hard to pick out if it's there, but it freaked me out a bit.

Thanks for any advice!
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Follow up: Dr. Dr. Vasudha (0 minute later)
Hi there. 40 year old male here, overweight but working out on average 6-7 days a week, trying to eat healthy, etc. I'm trying to stave off high blood pressure (mine fluctuates to <120/<80 occasionally to more common a little above 120/80, but generally not over 140/90 and usually quite a bit below that.

I have a bit of anxiety, which might be contributing to this, but I swear I can very mildly see the pulse at the sides of my neck if I look closely in the mirror. It is NOT obvious or prominent, and it may even come down to feeling my heartbeat in general, as I sometimes am unfortunately aware of it. If anything it's just a very slight movement; breathing actually makes it move more. I just noticed the other day what I thought to be my pulse there, and I'm wondering if it's normal to ever visually detect it along the sides of the neck? It's very hard to pick out if it's there, but it freaked me out a bit.

Thanks for any advice!
doctor
Answered by Dr. Dr. Vasudha (2 hours later)
Brief Answer:
Please start with specific care.

Detailed Answer:
Hi Shoun,
Thanks for the query.I have gone through it&understand your concern.
* Actually, blood pressure forms an important aspect of health..so it should never be taken lightly, & a detailed physical examination &needful investigations must be done to know basic cause, know about what personal care is needful&weather medicines are needed...one should not try to solve the problem on personal level.
* After reading the information given by you I feel the most possible cause for your problem seems to be your weight....in spite of working out for 6-7 days a week..&taking healthy diet, it's not getting controlled
The weight may be increased due to some other health conditions like Diabetes or Thyroid problem or increased cholesterols
I would suggest to get investigated for all of these conditions &start with altered life style & medications as per need.
Weight reduction has major role in reducing&stabilising blood pressure.
*Apart from self care including restricted diet ,no fast food, salt restrictions/ regular 40 minutes exercises,/sound sleep with positive &composed mind/ No smoking or alcohol/no psychological or physical stress ...needful medication would help a lot.
*About neck pulsations...soft pulsations are seen in thin neck even in normal person.
Though your blood pressure is not so high to take tension of such pulsation, in obese patients with long standing pulsations&increased cholesterol sometimes we need to advise certain tests to exclude probable problem
For all of this,to get personal specific advise,I would recommend to consult a physician.
I have tried to inform you the things you need .If you need some more information,please ask .I would like to help.
Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Vasudha (0 minute later)
Brief Answer:
Please start with specific care.

Detailed Answer:
Hi Shoun,
Thanks for the query.I have gone through it&understand your concern.
* Actually, blood pressure forms an important aspect of health..so it should never be taken lightly, & a detailed physical examination &needful investigations must be done to know basic cause, know about what personal care is needful&weather medicines are needed...one should not try to solve the problem on personal level.
* After reading the information given by you I feel the most possible cause for your problem seems to be your weight....in spite of working out for 6-7 days a week..&taking healthy diet, it's not getting controlled
The weight may be increased due to some other health conditions like Diabetes or Thyroid problem or increased cholesterols
I would suggest to get investigated for all of these conditions &start with altered life style & medications as per need.
Weight reduction has major role in reducing&stabilising blood pressure.
*Apart from self care including restricted diet ,no fast food, salt restrictions/ regular 40 minutes exercises,/sound sleep with positive &composed mind/ No smoking or alcohol/no psychological or physical stress ...needful medication would help a lot.
*About neck pulsations...soft pulsations are seen in thin neck even in normal person.
Though your blood pressure is not so high to take tension of such pulsation, in obese patients with long standing pulsations&increased cholesterol sometimes we need to advise certain tests to exclude probable problem
For all of this,to get personal specific advise,I would recommend to consult a physician.
I have tried to inform you the things you need .If you need some more information,please ask .I would like to help.
Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Vasudha (39 minutes later)
I have anxiety about BP, so it's hard to get a good reading, but I do take home readings for my doctor before each appointment with two different monitors. That said, my doctor seems fairly happy with my readings and doesn't think medication is necessary at this time.

As far as weight, I have lost a little bit, but it is very difficult for me to lose more unfortunately. I have upped my exercised and am trying intermittent fasting, which have helped a bit, but I still have a ways to go.

Regarding weight, I have been investigated for thyroid (tested normal) as well as diabetes (which I don't have). Cholesterol is also normal and actually fairly low. The one area that's not good is low HDL (though that appears to be genetic for me and there doesn't appear to be a good way to raise that as I'm already doing all the things that should). My doctor is fairly happy with my cholesterol numbers overall.

I don't smoke. I do drink, though I try to keep that moderate. I have anxiety but am working on controlling that.

Regarding the neck pulsations and feeling my heartbeat occasionally, as long as blood pressure is not extremely elevated, would you say it could be normal? Again, these are not prominent to the point where sometimes I feel like I'm not sure I'm seeing it, but other times I think I see a soft pulsation with my heartbeat. I just need to know if that's anything to be particularly alarmed about.

Thanks.
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Follow up: Dr. Dr. Vasudha (0 minute later)
I have anxiety about BP, so it's hard to get a good reading, but I do take home readings for my doctor before each appointment with two different monitors. That said, my doctor seems fairly happy with my readings and doesn't think medication is necessary at this time.

As far as weight, I have lost a little bit, but it is very difficult for me to lose more unfortunately. I have upped my exercised and am trying intermittent fasting, which have helped a bit, but I still have a ways to go.

Regarding weight, I have been investigated for thyroid (tested normal) as well as diabetes (which I don't have). Cholesterol is also normal and actually fairly low. The one area that's not good is low HDL (though that appears to be genetic for me and there doesn't appear to be a good way to raise that as I'm already doing all the things that should). My doctor is fairly happy with my cholesterol numbers overall.

I don't smoke. I do drink, though I try to keep that moderate. I have anxiety but am working on controlling that.

Regarding the neck pulsations and feeling my heartbeat occasionally, as long as blood pressure is not extremely elevated, would you say it could be normal? Again, these are not prominent to the point where sometimes I feel like I'm not sure I'm seeing it, but other times I think I see a soft pulsation with my heartbeat. I just need to know if that's anything to be particularly alarmed about.

Thanks.
doctor
Answered by Dr. Dr. Vasudha (8 hours later)
Brief Answer:
Not to be alarmed..but should be careful.

Detailed Answer:
Hi Shoun,
Thanks for the follow up query...it clearly expressed what exactly your concerns are...I would try to stick to those points now.(To be XXXXXXX I am always more sensitive about health issues of young people&wish to provide them all pros&cons of their health issue) Any way,
* Your primary concern is about the neck pulsations ,though not excessive,you feel/can observe .
The neck pulse seen in neck at jaw angle..is called carotid pulse.It is the strongest pulse in body, as it is arterial pulse &is just under skin.
Thats why it can be seen even in normal conditions...we physicians are bothered about it when there is difference in amplitude of the pulse on both sides...
Well you are under observation of your doctor for blood pressure ,so need not worry about it,he must be observing it too.
So relax!
* Your next concern is feeling of your heart beats .It is normal to feel it with breathing,exercises, anxiety-stress.
So while the blood pressure is normal or not much raised &other risk factors are excluded..yes it can be said to be normal.
** Here I would like to stress again about-
-Anxiety management.
-Low HDL cholesterol.(High dencity cholesterol) please let me be clear, genetics means genetic pre disposal to certain health aliment .It increases chance of getting the illness, when other causes for the condition are present.
HDL cholesterol works as scavenger &gets rid of harmful Low density cholesterol from where they should not be deposited(specially inner lining of blood vessels ..thus reducing the lumen of blood vessel-')
This condition is called Athrosclerosis &it can raise blood pressure.
* So though blood pressure is not much at present.&you are trying hard to get a control ..In my view all the possible factors should be controlled now itself ,so that you will not need any medication in future too.
I hope you get my point now.
Any more follow up query you have is welcome.
Thanks.




Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Vasudha (0 minute later)
Brief Answer:
Not to be alarmed..but should be careful.

Detailed Answer:
Hi Shoun,
Thanks for the follow up query...it clearly expressed what exactly your concerns are...I would try to stick to those points now.(To be XXXXXXX I am always more sensitive about health issues of young people&wish to provide them all pros&cons of their health issue) Any way,
* Your primary concern is about the neck pulsations ,though not excessive,you feel/can observe .
The neck pulse seen in neck at jaw angle..is called carotid pulse.It is the strongest pulse in body, as it is arterial pulse &is just under skin.
Thats why it can be seen even in normal conditions...we physicians are bothered about it when there is difference in amplitude of the pulse on both sides...
Well you are under observation of your doctor for blood pressure ,so need not worry about it,he must be observing it too.
So relax!
* Your next concern is feeling of your heart beats .It is normal to feel it with breathing,exercises, anxiety-stress.
So while the blood pressure is normal or not much raised &other risk factors are excluded..yes it can be said to be normal.
** Here I would like to stress again about-
-Anxiety management.
-Low HDL cholesterol.(High dencity cholesterol) please let me be clear, genetics means genetic pre disposal to certain health aliment .It increases chance of getting the illness, when other causes for the condition are present.
HDL cholesterol works as scavenger &gets rid of harmful Low density cholesterol from where they should not be deposited(specially inner lining of blood vessels ..thus reducing the lumen of blood vessel-')
This condition is called Athrosclerosis &it can raise blood pressure.
* So though blood pressure is not much at present.&you are trying hard to get a control ..In my view all the possible factors should be controlled now itself ,so that you will not need any medication in future too.
I hope you get my point now.
Any more follow up query you have is welcome.
Thanks.




Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Dr. Vasudha (11 hours later)
Thanks so much for the detailed response.

Your answer makes me feel much better about the neck pulse. I also viewed some YouTube videos showing where that pulse is (on healthy people) where I could clearly see the same type of movement in them as I'm seeing, so I really think it's something I just happened to notice and got a little anxious about, but is normal for most people. (I also saw some examples of abnormal ones, and this is definitely not that.)

Also good to know regarding feeling my heartbeats, and I do believe that's decreased a little bit as I've worked to get healthier/fitter.

Blood Pressure average over several readings different times is around 126/82, which is a little bit down from where it used to be (as is weight by a few pounds). While I'd like to get both a little lower yet, my doctor seemed to think this BP was fine and nothing I needed medication for at this time as long as I'm continuing to work on lifestyle.

HDL, there's just not much I can do to boost it. The main things to boost that are eating healthy, exercise, and even moderate alcohol, and those are all things I'm already working to do. But my HDL:LDL ratio isn't bad (though not ideal either, mainly because of the low HDL) given my other numbers (LDL/Triglycerides/LPa, etc.) are also low. So my doctor doesn't seem too worried about it. I also take supplements to HOPEFULLY help with the reverse cholesterol transport and heart health in general, such as garlic, CoQ10, fish oil, etc.

Finally, I am doing work on anxiety management and have actually been doing better overall as of late. My biggest area of anxiety is definitely health, but I try not to focus on worrying about that most of the time and instead put that energy into trying to better it. Still, when I notice something like the neck pulses, it can throw me for a loop for a bit. I appreciate your patience in helping me.
default
Follow up: Dr. Dr. Vasudha (0 minute later)
Thanks so much for the detailed response.

Your answer makes me feel much better about the neck pulse. I also viewed some YouTube videos showing where that pulse is (on healthy people) where I could clearly see the same type of movement in them as I'm seeing, so I really think it's something I just happened to notice and got a little anxious about, but is normal for most people. (I also saw some examples of abnormal ones, and this is definitely not that.)

Also good to know regarding feeling my heartbeats, and I do believe that's decreased a little bit as I've worked to get healthier/fitter.

Blood Pressure average over several readings different times is around 126/82, which is a little bit down from where it used to be (as is weight by a few pounds). While I'd like to get both a little lower yet, my doctor seemed to think this BP was fine and nothing I needed medication for at this time as long as I'm continuing to work on lifestyle.

HDL, there's just not much I can do to boost it. The main things to boost that are eating healthy, exercise, and even moderate alcohol, and those are all things I'm already working to do. But my HDL:LDL ratio isn't bad (though not ideal either, mainly because of the low HDL) given my other numbers (LDL/Triglycerides/LPa, etc.) are also low. So my doctor doesn't seem too worried about it. I also take supplements to HOPEFULLY help with the reverse cholesterol transport and heart health in general, such as garlic, CoQ10, fish oil, etc.

Finally, I am doing work on anxiety management and have actually been doing better overall as of late. My biggest area of anxiety is definitely health, but I try not to focus on worrying about that most of the time and instead put that energy into trying to better it. Still, when I notice something like the neck pulses, it can throw me for a loop for a bit. I appreciate your patience in helping me.
doctor
Answered by Dr. Dr. Vasudha (23 minutes later)
Brief Answer:
Thanks & best wishes!

Detailed Answer:
Hi Shoun,
Thanks for the response.I am sure. self inspired&determined person like you,would definitely achieve the goal & gain complete physical fitness soon!
Wishing you best of the best!
I would like to assist you for any health information you need any time.
I am available on Health care magic 'Ask doctor' service.'
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Dr. Vasudha (0 minute later)
Brief Answer:
Thanks & best wishes!

Detailed Answer:
Hi Shoun,
Thanks for the response.I am sure. self inspired&determined person like you,would definitely achieve the goal & gain complete physical fitness soon!
Wishing you best of the best!
I would like to assist you for any health information you need any time.
I am available on Health care magic 'Ask doctor' service.'
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr. Vasudha

General & Family Physician

Practicing since :1970

Answered : 9375 Questions

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Hi There. 40 Year Old Male Here, Overweight But Working

Hi there. 40 year old male here, overweight but working out on average 6-7 days a week, trying to eat healthy, etc. I'm trying to stave off high blood pressure (mine fluctuates to <120/<80 occasionally to more common a little above 120/80, but generally not over 140/90 and usually quite a bit below that. I have a bit of anxiety, which might be contributing to this, but I swear I can very mildly see the pulse at the sides of my neck if I look closely in the mirror. It is NOT obvious or prominent, and it may even come down to feeling my heartbeat in general, as I sometimes am unfortunately aware of it. If anything it's just a very slight movement; breathing actually makes it move more. I just noticed the other day what I thought to be my pulse there, and I'm wondering if it's normal to ever visually detect it along the sides of the neck? It's very hard to pick out if it's there, but it freaked me out a bit. Thanks for any advice!