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Suggest Treatment For High BP

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Posted on Fri, 27 Mar 2015
Question: Hi. I am 29 years old and have high blood pressure. I started seeing a cardiologist because of my family history of heart disease and my PCP had me on three BP meds. My cardiologist put me on Tribenzor to cut it down to one pill. I am also on Simvastatin 20 mg - my cholesterol is within normal limits now. My blood pressures are much improved, although systolic in my left arm is always 10-20 mmhg higher than the the right. Before exercise, my left arm averages around 125/70 while the right will be around 113/70. After exercise my left will be around 110/60 while the right arm can be as low as 98/55ish. I exercise 3-4 times per week and eat a low fat, high protein, plant based diet. Even though my blood pressures are technically within normal limits, should I be concerned about the difference? My cardiologist says they do not typically intervene unless there are symptoms. I am very paranoid about this, which I am sure doesn't help. Any input is appreciated.
doctor
Answered by Dr. Lilit Baghdasaryan (4 hours later)
Brief Answer:
Can be a normal finding, for confirming duplex ultrasound is recommended

Detailed Answer:
Dear Sir,

10 mm Hg difference between arms is permitted and is not considered abnormal. Sometimes 10-20 also can be seen without any abnormality.
The abnormal difference can be seen only when there is a periphery artery disease in upper extremities. So, if you are concerned much I would advise you to undergo duplex ultrasound of arteries of upper extremities. If it comes back normal then there is nothing to worry.

Hope I could help you

Wishing you good health

In case of further questions don't hesitate to ask

Regards,


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (7 hours later)
Is the a common finding for a 29 year old male? Since my cardiologist was not overly concerned, is this something that can wait until my next appointment in october? I appreciate your assistance!
doctor
Answered by Dr. Lilit Baghdasaryan (17 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

It is not very common, but usually in your age there is nothing dangerous. You can safely wait until your appointment.

Anyway I would recommend to perform duplex ultrasound of upper extremities and aorta. It is not urgent and not dangerous. You can do it during next 6 months.

Wishing you good health

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (20 minutes later)
Sorry for all of the questions- why would the aorta be a concern? I have also read something about thoracic outlet syndrome- I am a drummer and I suppose this could possibly have something to do with it as well?
doctor
Answered by Dr. Lilit Baghdasaryan (12 minutes later)
Brief Answer:
Welcome back

Detailed Answer:
Dear Sir,

The only reason I have recommended duplex ultrasound is to evaluate aorta and it's branches. Sometimes there is narrowed segment in aorta (coarctation), which can cause elevated blood pressure and blood pressure difference in arms.
It is quite rare. Anyway to be on the safe side , I would do the examination to rule out the coarctation if you were my patient.
But before the examination I think there is nothing to be concerned, it will not be dangerous even if you are a drummer.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (24 minutes later)
Thank you, at my initial cardiology appointment, I had an echocardiogram and a baseline electrocardiogram to assess a mumur. My cardiologist said both of these tests were normal and he would see me in a year. I will monitor my pressures until then and keep him updated. Thank you for your assistance.
doctor
Answered by Dr. Lilit Baghdasaryan (2 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
Wishing you good health

Regards,
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
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Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Suggest Treatment For High BP

Brief Answer: Can be a normal finding, for confirming duplex ultrasound is recommended Detailed Answer: Dear Sir, 10 mm Hg difference between arms is permitted and is not considered abnormal. Sometimes 10-20 also can be seen without any abnormality. The abnormal difference can be seen only when there is a periphery artery disease in upper extremities. So, if you are concerned much I would advise you to undergo duplex ultrasound of arteries of upper extremities. If it comes back normal then there is nothing to worry. Hope I could help you Wishing you good health In case of further questions don't hesitate to ask Regards,