question-icon

What causes high blood pressure?

default
Posted on Mon, 1 Dec 2014
Question: Hello,

My name is XXXX and I am 45 years old, female, living in London, UK for 14 years. My weight is 88kg and my height is 1.66m
I am writing concerning my episodes of high blood pressure and general feeling of lifeless.
About 1 1/2 weeks ago I started to feel very very week, to have slight pain in my chest above my left breast, with cold sweats, tingling in both my legs (feels like electricity), feeling of my feet getting un-numbed, weakness in my legs muscles, nausea at times and feeling that I Would pass out any minute (I did not pass out). I suffer also with asthma and acid reflux and 1/1/2 weeks ago my breathing was very difficult. I started taking double dose of brown inhales (clenil modulate) and of ventoling and slowly, in few days time, my breathing got better. About the same time I also started to monitor my blood pressure as I thought this might be the reason of feeling unwell. My blood pressure fluctuates from 145/95 to 162/103. I also take simvastatin 40mg for cholesterol, for over one year. I suffer also with allergic rhinitis and I am dependent on xylometazoline (I use the spray up to ten times a day). Four years ago I had a psychotic episode and I take Olanzapine 2.5 mg. I also suffer with acid reflux and lately I have difficulty in breathing, every time I eat, mainly soups (I started to take lansoprazole 15 mg).
On 1st of November I went to the Emergency room at the near hospital with high blood pressure - at home it showed 166 over 110. I also suffered with general weakness as described above and had slight pain in the chest- rate 4 out of 10. The blood pressure at the hospital showed 155/88 and after they have done several ECG and blood test (Including blood test to see some parameters of the heart's muscle), I was sent home and given paracetamol. They told me I probably had a viral infection due to the fact that my asthma was bad few days prior to my visit. Ever since that visit at hospital I got worst and worst in terms of general feeling of lifeless, cold sweats, etc etc. Sometimes I cant stand up- I have too sit down as I am very weak. At other times even sitting on a chair takes too much of my energy. This weekend it was worst then before, the pain in the chest was stronger- maybe 5-6 out of 10 and sometimes the pain irradiated to the shoulder and left side of my neck. Yesterday I felt also slight numbness in my chin. My blood pressure yesterday was 147/100 and pulse 74 at 7.00 am, 160/102 with 82 pulse at 11.57 after lunch, 146/96 with 75 pulse at 12.54, 155/101 with pulse 79 at 16.27 pm, 140/95 with pulse 85 at 21.43
This morning at 4.50 I woke up to use the toilet and started feeling very very weak and unwell and I took the blood pressure- it showed 188/125 with pulse 100. I had also same pain in the chest rated 5 out of ten. I called the ambulance and a first ambulance came. They took blood pressure and it showed 166/105 and they done a ECG and it came out fine. Second ambulance came who took me to the hospital. The blood pressure was 177/105. At the hospital I had several blood pressure test and the ones I remember are at 12.00 when it showed 137/87, at 14.10 when it showed 117/67 . They have done 3 ECG which they told me came out fine. They done all sorts of blood test : CBC, DIFF Count, Calcium, C-reactive protein, liver function test, magnesium, coagulation screen, urea and electrolytes and all came out ok- I can scan and send you tomorrow the report. They done an x-ray for my chest which came out fine, urine test that was fine. The diagnoses at discharge is Muscoloskeletal chest pain. They did not mention anything about my high blood pressure of this morning. They have done also kind of neurological tests (checking reflexes of arms, hands, legs and feet).

Next week on 17 November I have an appointment with a cardiologist to check my heart and discuss my blood pressure. I forgot to mention that I have polyps on my uterus and I need to have a hysteroscopy (where they will put me to sleep). I have postponed it as I was worried something might go wrong due to my fluctuating blood pressure. These polyps and the high blood pressure are the biggest worry for me at present.

Please let me know as follows, if possible:

1. what can be the reason for my high blood pressure? My father also suffers with high blood pressure and takes medication. He also suffered with arrhythmia and has a pacemaker. My mother had pericarditis when she was 50 years old and suffered a heart attack when she was 83- which she survived, At 86 years old she died, probably from another heart attack.
2. What should I do to decrease my blood pressure? The hospital did not give me any medication and I am worried I will be having high blood pressure again. My blood pressure this evening was 155/100 and now is 145 over 91. Could you please tell me if taking omega 3 tablets, magnesium B6 tablets, vitamin D, would reduce the blood pressure? what else can I do to decrease the blood pressure. Is Coenzyme Q 10 affecting negatively my blood pressure? How about vitamin C, vitamin B complex and Vitamin A? If I was in my country, Romania, the hospital would have kept me over night and continue with other investigations for the heart etc and monitor me. Here they only gave me paracetamol and co-codamol which made me feel like I was sedated (really dizzy and unwell).
3. What kind of test should I request to the cardiologist next Monday?
4. Do you think I am fit enough to have general anaesthesia in order to have hysteroscopy?
5. Why is the blood pressure fluctuating from normal to abnormal? Would I be able to be put on blood pressure medication or this might be risky as the blood pressure could get too low?

As I type now I feel electricity in my legs and pain in the shoulder and left side of the neck and general feeling of unwell. I have like flushes of feelings of going to pass out, from time to time. I also have light coloured stool (light brown- greenish) for few weeks now and I have stools 3-4 times a day, loose ones. I also suffer with haemorrhoids (internal- stage one, and external) and sometimes the internal ones bleed. I had sygmoidoscopy and came out fine other than reporting presence of haemorrhoids.

The hospital told me today that they think I still have this viral infection and it may take a while for me to get better. Is there any medication for that ? I don't think I have viral infection as I do not have symptoms of flue like cough or temperature or runny nose.

I look forward to having your kind advise

Many thanks and best regards Hello Again

I forgot to mention that I think I suffer with sleep apnoea as I wake up every night 3-4 times feeling I get suffocated as I do not have enough air and I jump out of bed scared and breathing through my mouth. I was told that I snore a lot as well and these things might affect my blood pressure?

Many thanks and best regards


XXXX


doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
I will try to answer all your queries.

Detailed Answer:
Hi and thank you for asking HCM!

Following i will try to answer all your queries:

1. there are to many causes of hypertension but in more then 98% of cases is without a known etiology (essential hypertension). I think this is your case although it may be caused from sleep apnoea. Treating hypertensionin this case will prevent future cardiovascular complications.

2. I would recommend starting medications ACE-inhibitors, diuretics (hydrochlortiazide) and calcium channel blockers (amlodipine) to control BP.

3. I would recommend the following examinations:
- ECG
- Cardiac ECHO
- Abdominal ultrasound (renal and suprarenal glands)
- Blood work
- BP monitoring and Holter monitoring

4. If all the results come back normal you are fit to general anesthesia for hysteroscopy.

5. You should start medications but you have to titrate the dose (increase slowly till the normalization of BP). This will prevent by excessive lowering of BP.

Hope this was of help!
Dr. Bneard
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Benard Shehu (8 hours later)
Dear Mr. Shehu,

thanks a lot for your reply.

I am having chest pain (just below left breast) harder than i had yesterday- maybe 6-7 out of 10. What can be the cause of this chest pain?

My blood pressure this morning was 185/111 at 6.48 and at 7.10 was 162/102

Please let me know what does Blood Work mean- is it full blood test?

How about the feeling of lifeless that i have? What could be the cause?

Last but not least., should i take Omega 3 tablets, Magnesium B6 and Vitamin D to lower the blood pressure? If yes, what should be the dose?

Many thanks and hope you have a nice day

Best Regards
XXXX
doctor
Answered by Dr. Benard Shehu (8 hours later)
Brief Answer:
Do the mentioned exams to find out the right diagnosis...

Detailed Answer:
Hi back,

1. The chest pain you are experiencing may be related to cardiac, pulmonary, abdominal or musculoskeletal problems. This is why I recommended you to do the mentioned examinations, to find out the right diagnosis.

2. Your BP is high so i recommend to start therapy immediately.

3. With blood works i mean a full blood tests (especially BUN, creatinine and cholesterol levels are of primary importance).

4. It's important to run all the mentioned examinations. If they are within the normal range then the feeling of lifeless is more of psychological origin.

5. Omega 3 tablets, Magnesium B6 and vitamin D are used to improve the quality of life and somehow they lower BP. I suggest to take them on a daily basis. However the dose is individual and should be suggested after physical examinations.

Wish you health!
Dr. Benard
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Benard Shehu (44 minutes later)
Many thanks Dr Shedu

do you think I should start medication from Thursday (I se my general practitioner tomorrow evening) or wait for cardiologist appointment which is on Monday 17 Nov 2014?

Thanks a lot for your hard work

Best regards

XXXX
doctor
Answered by Dr. Benard Shehu (17 minutes later)
Brief Answer:
You should start medication from Thursday.

Detailed Answer:
Welcome back again Luliana!

You should start medication from Thursday (immediately after seeing your GP). Earlier you start treatment, faster your BP will be stabilized and this will make you feel better.

Wish you health!
Dr. Benard
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Benard Shehu (5 hours later)
Thanks a lot Dr Shedu. I will talk to my GP

All the best to you too

Best regards

XXXX
doctor
Answered by Dr. Benard Shehu (4 minutes later)
Brief Answer:
Wish you health!

Detailed Answer:
Welcome back again.

It was a pleasure to assist you with my advices.

Wish you health!
Dr. Benard
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Benard Shehu (36 minutes later)
One more question Dr XXXXXXX

If I start on BP medication, can the cardiologist still do the tests you mentioned above or the results would not be relevant since I would be already on medication. In other words, should I still go for Cardiologist appointment on Monday the 17th?

All the best and many thanks

XXXX
doctor
Answered by Dr. Benard Shehu (27 minutes later)
Brief Answer:
The cardiologist can still do the exams...

Detailed Answer:
Hi back again,

You have nothing to worry about. The cardiologist can still do the mentioned examinations on Monday. Medical therapy doesn't interfere with test results.

Wish you all the best!
Dr. Benard
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Benard Shehu (36 hours later)
Dear Doctor Shehu

Many thanks for your advises so far. I saw my GP yesterday and he reluctantly gave me Ramipril 1.25 mg capsules, to be taken once a day, in the morning. He was reluctant as my BP was normal when I visited him- approximately 137/88. However, I showed him the results I get in the morning or in the middle of the night when I take my BP. Even this morning at 3.00 am the BP was 180/103 and one minute later was 169/108. I then took my first Ramipril tablet.

I did feel very bad this morning- high palpitations, feeling of passing out, dizziness and pain in the chest- but BP and pulse was normal-157/97 with pulse 82. Is this normal when taking BP tablets?

Once again thanks a lot for your great help

Have a lovely day

XXXX
doctor
Answered by Dr. Benard Shehu (10 hours later)
Brief Answer:
Monitoring of BP is needed for Ramipril titration.

Detailed Answer:
Hi back Luliana,

Nice to hear from you again.

I advise to monitor your Blood pressure (bP), record the results and get them analyzed by your doctor. Based on readings, dose of Ramipril will be adjusted accordingly.

All the best!
Dr. Benard
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes high blood pressure?

Brief Answer: I will try to answer all your queries. Detailed Answer: Hi and thank you for asking HCM! Following i will try to answer all your queries: 1. there are to many causes of hypertension but in more then 98% of cases is without a known etiology (essential hypertension). I think this is your case although it may be caused from sleep apnoea. Treating hypertensionin this case will prevent future cardiovascular complications. 2. I would recommend starting medications ACE-inhibitors, diuretics (hydrochlortiazide) and calcium channel blockers (amlodipine) to control BP. 3. I would recommend the following examinations: - ECG - Cardiac ECHO - Abdominal ultrasound (renal and suprarenal glands) - Blood work - BP monitoring and Holter monitoring 4. If all the results come back normal you are fit to general anesthesia for hysteroscopy. 5. You should start medications but you have to titrate the dose (increase slowly till the normalization of BP). This will prevent by excessive lowering of BP. Hope this was of help! Dr. Bneard