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Suggest Treatment For High BP And Chest Pain

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Posted on Tue, 11 Oct 2016
Question: I would like to know the significance of high blood pressure. I regularly have readings over 130 over 89 pulse and ranges between 64 bpm and 112 bpm. Mostly the blood pressure is 150 over 125. My doctor says this is normal but when last taken in the centre 2 weeks ago it was 170 over 125. What is going on and I have had chest pain occasionally and rest helps. Not panicing or anxious. Gp ignores this aas ECG was supposedly fine.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I carefully passed through your question and reviewed your past medical history.

Your blood pressure values are above the normal ranges, indicating stage I hypertension.

High blood pressure could be a primary hypertension (without any known cause) or secondary hypertension (related to kidney or liver disease, thyroid dysfunction, inflammatory disease, drug induced etc.)

I would recommend consulting with your GP and performing some tests to exclude other secondary causes of high blood pressure:

- a chest X ray study
- complete blood count
- PCR and sedimentation rate for inflammation
- thyroid hormone levels
- fasting glucose and HbA1C for diabetes
- blood electrolyts
- kidney and liver function tests
- blood lipid profile.

Anxiety could also raise your blood pressure and also cause the chest pain.

Anyway, if your chest pain is triggered during physical activity, a cardiac stress test would help exclude possible coronary artery disease.

I would also recommend starting antihypertensive therapy in order to have a better control of your blood pressure values. As you have not tolerated well Ramipril, I would recommend starting an ARB like valsartan or a calcium channel blocker like amlodipine, etc..

Some modifications to your lifestyle would help manage better your blood pressure:

- diet modifications (reduce salt and caffeine intake)
- perform a lot of physical activity (walking, aerobics, recreational sports)
- try to lose some weight if you are overweight.

Hope to have been helpful!

Feel free to ask me again whenever you nee!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (36 hours later)
Thank you for your reply.
I am vegetarian part vegan. No fish, meat, eggs etc. Diabetic as well. Due to health conditions explained cannot walk far. It is difficult to get around the house Often not upstairs.
Blood tests came back fine according to my doctor except diagnosed diabetes although it is not stated which type. (I assume type 2 diet controlled as this is my assumption based on family history). This makes changes difficult.
Is cardiac stress test the same as an ECG. ECG was done in surgery and said to be fine?
Chest pain has been when just happily pottering about the house and not under any undue physical activity nor anxiety. I was calm and just knew I had to rest up sitting until pain subsided. Approx 30 minutes duration. Then pain went away and I just carried on. The pain is in centre of chest and had this twice in the last year. I also had a short spell of fast beating feeling in the chest several times but no pain.
Doctor refuses to consider medication no explanation given. It is obvious as this is clarified by lack of prescription and lack of stating which diabetes I have. Can I have over counter medication? I drink approx. 4 cups of tea a day and other drinks sugar and caffeine free. I do not take sugar or salt in my diet either. Thank you for your help
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

The presence of diabetes imposes you to an elevated cardio-vascular risk , especially when coupled with high blood pressure.

I would strongly recommend performing the cardiac stress test. It is not the same thing as resting ECG, because is examines the cardiac function and possible changes in the coronary artery blood flow during physical effort.

This exam is important to exclude possible coronary artery disease underlying your chest pain.

I would also recommend discussing with your attending physician on the possibility of making further changes to your antihypertensive therapy (switching to an ARB like valsartan, etc. or a calcium channel blocker like amlodipine) in order to have a better control of your blood pressure values.

My advise is to continue on your actual healthy diet.

Hope to have been helpful!

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
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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Suggest Treatment For High BP And Chest Pain

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on HCM! I carefully passed through your question and reviewed your past medical history. Your blood pressure values are above the normal ranges, indicating stage I hypertension. High blood pressure could be a primary hypertension (without any known cause) or secondary hypertension (related to kidney or liver disease, thyroid dysfunction, inflammatory disease, drug induced etc.) I would recommend consulting with your GP and performing some tests to exclude other secondary causes of high blood pressure: - a chest X ray study - complete blood count - PCR and sedimentation rate for inflammation - thyroid hormone levels - fasting glucose and HbA1C for diabetes - blood electrolyts - kidney and liver function tests - blood lipid profile. Anxiety could also raise your blood pressure and also cause the chest pain. Anyway, if your chest pain is triggered during physical activity, a cardiac stress test would help exclude possible coronary artery disease. I would also recommend starting antihypertensive therapy in order to have a better control of your blood pressure values. As you have not tolerated well Ramipril, I would recommend starting an ARB like valsartan or a calcium channel blocker like amlodipine, etc.. Some modifications to your lifestyle would help manage better your blood pressure: - diet modifications (reduce salt and caffeine intake) - perform a lot of physical activity (walking, aerobics, recreational sports) - try to lose some weight if you are overweight. Hope to have been helpful! Feel free to ask me again whenever you nee! Kind regards, Dr. Iliri