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Dr. Andrew Rynne

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On medication for BP. What should I do to control BP level?

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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

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Posted on Sat, 15 Dec 2012 in Hypertension and Heart Disease
Question: Am having BP problem from last 1 year, taking medicine as mentioned in current medications and having normal bp from last 4-5 months.

In May 2012, during my executive health check up, Stress test report came positive then my cardio suggested to go for angiography to get all doubts clear. Fortunately, Angio report came normal in May 2012 since then till Oct 12 end my BP was in normal range.

On 4th Nov, suddenly my BP XXXXXXX to 180/100. Doctor suggested to increase the dose of Cardace from 2.5 to 5 mg in Mor & eve. For 15-20 days, BP remained in the range of 140-90 now gradually coming down.

Query :-

i) What could be the reason for increase in BP despite no cardic problem
ii) I am regulare in my exercise ( Morning & Eve Walk) still i have not seen any drop in my weight, what could be the reason
iii) What should I do to keep my BP normal with less of medicine
iv) Despite Angio report coming normal, still there could be any change of cardic issue.

doctor
Answered by Dr. Anantharamakrishnan 1 hour later
Hi Mr XXXXXXX
Welcome to Health Care Magic
_________________________________________________
i.     There are several causes for the blood pressure – Inheritance is the commonest. Kidney is very important. There are several others like stress, hormones like adrenaline and so on.
It needs a whole battery of investigations to search for a cause; yet the success rate is rather poor.
Most times, we treat the pressure, not the cause.
_________________________________________________
ii.     Weight is like bank account. The account grows when you withdraw less (reducing physical activity) and you deposit more (eat more). If the weight is not coming down, it only means – the exercise is not enough or the food is more.

     Consider – A cup of rice or an average bar of chocolate has approximately 200 calories.
– In walking 1 kilometre, one spends 1 Calorie per kilogram of his body weight!

     You have to reduce the quantity of your food and change the quality too.
You should see a good dietician - One generally needs several sessions, to master the nuances.
_________________________________________________
iii.     When the BP is normal, you must continue the medicines.
When the car is running, we can not switch the engine off!
You should be following up with your doctor regularly. In the rare case of the reason for the raise being transient and if the pressure has been controlled well for 2 or more years – one can try to reduce (not stop) the dose.
_________________________________________________

iv.     A normal angio is greatly reassuring. It outlines the anatomy of large vessels.
Spasm may at times contribute. There may be ‘small vessel disease’ which is difficult to document.
_________________________________________________

As it is, the questions are more theoretical!
From the practical point of view, your present doctor is doing a good job and you must be following up with him
_________________________________________________

Take care
Wishing speedy recovery
God bless
Good luck

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