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Suggest Treatment For High BP
Question: I need advice regarding my continued raised BP which I have been trying to get to normal with life style changes. Not succeeding.
Brief Answer:
Follow life style changes as advised for 3months
Detailed Answer:
Hi dear,
Firstly thanks for selecting health care magic to ask your query !
Blood pressure has been classified into five catagories according to JACC.
Normal blood pressure < 120/80
prehypertensive stage is 120-139/80-89
grade 1 (mild ) is 140-159/90-99
grade 2 (moderate ) is 160-179/100-109
above that is severe hypertension.
As age progresses the blood vessels loses their elasticity due to age related changes and atherosclerosis(fat deposition ) ,hence blood pressure increases with age and its natural .
At a age more then 45 years in male our target blood pressure is 140/90.
Less then 120/80 is said normal in a young adult but in older person the target b.p is less then 140/90.
Your systolic b.p varies between 116-150 and diastolic varies between 79-92 mm of hg .
So as per the guideliness of JACC ,your maximum blood pressure reading 150 systolic and 92 diastolic comes under mild (grade 1) hypertension(in respect to criteria laid down for young person)
At a age of 78 our target is to achieve a b.p less then 140/90 mm of hg and you are very close to it ;just follow my advice for 3 months.
Do 45 minutes of strenous exercise atleast 6 days a week ,just walking will not help ,if you walk ;walk should be brisk at a speed of atleast 5.1km/hr.
Use salt restricted diet 1500mg of sodium per day.
Add lots of fibres to your diet.
Avoid oily and fatty food,dont take butter ,peanut oil instead eat oats ,and use rice XXXXXXX oil or olive oil.
Avoid red meat and egg yolk.
Don't take any medicine for the time being .
Do what i suggested you for at least 3 months ,keep a record of your blood pressure every 3rd day ,your readings will be much better after 3 months.In case even after 3months of severe life style mofification trial we fail to achieve our target b.p , then we would start you with a very low dose of antihypertensive medicine.
Dont be over anxious about your b.p as increased anxiety levels also elevates blood pressure ,frankly speaking according to your age your b.p is just a bit high ,so don't worry ,just follow life style modification by heart for 3 months and you will be fine.
In case you need more clarification or you have any more query ,feel free to ask!
Thanks
Dr Rishu Saxena
Cardiologist
Follow life style changes as advised for 3months
Detailed Answer:
Hi dear,
Firstly thanks for selecting health care magic to ask your query !
Blood pressure has been classified into five catagories according to JACC.
Normal blood pressure < 120/80
prehypertensive stage is 120-139/80-89
grade 1 (mild ) is 140-159/90-99
grade 2 (moderate ) is 160-179/100-109
above that is severe hypertension.
As age progresses the blood vessels loses their elasticity due to age related changes and atherosclerosis(fat deposition ) ,hence blood pressure increases with age and its natural .
At a age more then 45 years in male our target blood pressure is 140/90.
Less then 120/80 is said normal in a young adult but in older person the target b.p is less then 140/90.
Your systolic b.p varies between 116-150 and diastolic varies between 79-92 mm of hg .
So as per the guideliness of JACC ,your maximum blood pressure reading 150 systolic and 92 diastolic comes under mild (grade 1) hypertension(in respect to criteria laid down for young person)
At a age of 78 our target is to achieve a b.p less then 140/90 mm of hg and you are very close to it ;just follow my advice for 3 months.
Do 45 minutes of strenous exercise atleast 6 days a week ,just walking will not help ,if you walk ;walk should be brisk at a speed of atleast 5.1km/hr.
Use salt restricted diet 1500mg of sodium per day.
Add lots of fibres to your diet.
Avoid oily and fatty food,dont take butter ,peanut oil instead eat oats ,and use rice XXXXXXX oil or olive oil.
Avoid red meat and egg yolk.
Don't take any medicine for the time being .
Do what i suggested you for at least 3 months ,keep a record of your blood pressure every 3rd day ,your readings will be much better after 3 months.In case even after 3months of severe life style mofification trial we fail to achieve our target b.p , then we would start you with a very low dose of antihypertensive medicine.
Dont be over anxious about your b.p as increased anxiety levels also elevates blood pressure ,frankly speaking according to your age your b.p is just a bit high ,so don't worry ,just follow life style modification by heart for 3 months and you will be fine.
In case you need more clarification or you have any more query ,feel free to ask!
Thanks
Dr Rishu Saxena
Cardiologist
Above answer was peer-reviewed by :
Dr. Raju A.T
Doctor Rishu,
Thank you for your prompt reply.
You have confirmed what I had thought. That my raised BP was not that bad. I had thought that my own GPs conclusion of medication was hasty.
My wife of 55 years always tells me it is my anxiety and driven personality type is the cause of all my problems. I.e. Migraine, stress and nerves.
I will follow your advice as much as I am able. We are off on a cruise ship for 4 weeks on Thursday. They will have a gym. Plus of course lots of wicked food. On our return I will re join a gym.
My follow up question to you as a cardiologist is what worries me most. Because my BP rises as the day progresses from normal in the morning to above normal before bed, would that and the fact that I puff a bit walking up hill indicate that there may be some arterial blockage. An ECG a year ago, passive and on a bike, was all fine. I have never had any other tests. I was told 25 years ago that I had a right bundle branch block which the cardiologist put down to my then marathon running.
I am sure you will read this and put me down as " The worried well" However I do appreciate your advice.
Thank you most sincerely.
Thank you for your prompt reply.
You have confirmed what I had thought. That my raised BP was not that bad. I had thought that my own GPs conclusion of medication was hasty.
My wife of 55 years always tells me it is my anxiety and driven personality type is the cause of all my problems. I.e. Migraine, stress and nerves.
I will follow your advice as much as I am able. We are off on a cruise ship for 4 weeks on Thursday. They will have a gym. Plus of course lots of wicked food. On our return I will re join a gym.
My follow up question to you as a cardiologist is what worries me most. Because my BP rises as the day progresses from normal in the morning to above normal before bed, would that and the fact that I puff a bit walking up hill indicate that there may be some arterial blockage. An ECG a year ago, passive and on a bike, was all fine. I have never had any other tests. I was told 25 years ago that I had a right bundle branch block which the cardiologist put down to my then marathon running.
I am sure you will read this and put me down as " The worried well" However I do appreciate your advice.
Thank you most sincerely.
Brief Answer:
Variation in B.P is a part of normal body cycle,RBBB i normal in 85% cases.
Detailed Answer:
Hi, XXXXXXX
Right bundle branch block is normal finding in 85% of cases, unless 2d echo of a patient shows some problem with left ventricle ejection fraction of heart ,or the patient is symptomatic,no medications are used for RBBB.
Unless symptomatic RBBB has no significance and i don't know why your cardiologist at that time stopped you from marathon running.
Though the loss of normal coordination between the two ventricles can reduce the efficiency of the heart beat. However, the reduction in the heart's efficiency is less pronounced in RBBB ,hence a person can do all normal things unless he is symptomatic.
Puffing a bit at a age of 78 ,is normal ;yet to be on safer side i would suggest you to go for a STRESS THALLIUM TEST, sensitivity of this test is more then 97% for coronary artery disease,and if its normal then you are cleared from cardiac side(Going through your history ,i know it will be normal),But as you wan to be sure you can go through a stress thallium,Its a non invasive test so you can do it easily.
Breathlessness on exertion can be a sign of coronary artery disease but considering your age , feeling a bit breathless while walking up hill is normal,But to be on a safer side a STRESS THALLIUM can be done.
Everything in our body has a pattern,same is true with blood pressure also.
Blood pressure has a daily pattern. Blood pressure is normally lower at mid night while you're sleeping.Your blood pressure starts to rise a few hours before you wake up,Your blood pressure continues to rise during the day, usually peaking in the evening time,Then in the late evening, your blood pressure begins dropping again.This cycle is followed in most of the individuals ,however golden rule of medical science is that there is no rule,every body is different .Don't worry too much about that ,its natural .
As i have already explained in my first answer that blood pressure is divided into various ranges ,so a variation of +-10mm of hg is perfectly normal,and you need not to worry about it.A cardiologist treats patient according to symptoms not according to numbers.
Overthinking can increase anxiety levels in your brain and can elevate your base line blood pressure.
So don't worry considering your age your blood pressure is almost fine,mild variations are a part of our body cycle so don't be over conscious about that.
Follow whatever i advised, no need to restrict any activity because of RBBB.
Measure your B.P once every week and keep a record of it in your log.
If you want any other detail or have any other query ,feel free to ask,i would be happy to help you!
If you are satisfied with my answers please do leave a review !
Thanks
Dr Rishu Saxena
Cardiologist
(Enjoy your trip ,good luck)
Variation in B.P is a part of normal body cycle,RBBB i normal in 85% cases.
Detailed Answer:
Hi, XXXXXXX
Right bundle branch block is normal finding in 85% of cases, unless 2d echo of a patient shows some problem with left ventricle ejection fraction of heart ,or the patient is symptomatic,no medications are used for RBBB.
Unless symptomatic RBBB has no significance and i don't know why your cardiologist at that time stopped you from marathon running.
Though the loss of normal coordination between the two ventricles can reduce the efficiency of the heart beat. However, the reduction in the heart's efficiency is less pronounced in RBBB ,hence a person can do all normal things unless he is symptomatic.
Puffing a bit at a age of 78 ,is normal ;yet to be on safer side i would suggest you to go for a STRESS THALLIUM TEST, sensitivity of this test is more then 97% for coronary artery disease,and if its normal then you are cleared from cardiac side(Going through your history ,i know it will be normal),But as you wan to be sure you can go through a stress thallium,Its a non invasive test so you can do it easily.
Breathlessness on exertion can be a sign of coronary artery disease but considering your age , feeling a bit breathless while walking up hill is normal,But to be on a safer side a STRESS THALLIUM can be done.
Everything in our body has a pattern,same is true with blood pressure also.
Blood pressure has a daily pattern. Blood pressure is normally lower at mid night while you're sleeping.Your blood pressure starts to rise a few hours before you wake up,Your blood pressure continues to rise during the day, usually peaking in the evening time,Then in the late evening, your blood pressure begins dropping again.This cycle is followed in most of the individuals ,however golden rule of medical science is that there is no rule,every body is different .Don't worry too much about that ,its natural .
As i have already explained in my first answer that blood pressure is divided into various ranges ,so a variation of +-10mm of hg is perfectly normal,and you need not to worry about it.A cardiologist treats patient according to symptoms not according to numbers.
Overthinking can increase anxiety levels in your brain and can elevate your base line blood pressure.
So don't worry considering your age your blood pressure is almost fine,mild variations are a part of our body cycle so don't be over conscious about that.
Follow whatever i advised, no need to restrict any activity because of RBBB.
Measure your B.P once every week and keep a record of it in your log.
If you want any other detail or have any other query ,feel free to ask,i would be happy to help you!
If you are satisfied with my answers please do leave a review !
Thanks
Dr Rishu Saxena
Cardiologist
(Enjoy your trip ,good luck)
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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