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    What does my angiography result report indicate?

Posted on Thu, 9 Nov 2017 in Hypertension and Heart Disease
Question: Hi

I am posting this question regarding my mother’s health issue.

My mother is 59 years in age. She has problem of high BP from last 10 years and it has been under control with medicines. Recently from last 2 months , her BP has started fluctuating a lot. We met cardiologist and he changed medicines and BP got controlled intermittently. After she takes medicine bp is 135/80 but before her regular time of medicine it shoots upto180/100. Doctor has asked us to control bp first and he is clueless about these spikes. We stay in small place and it takes time to reach in case of emergencies.

Last year angiography was done and it came negative with zero blockages. Although on TMT her target heart rate was achieved in just 3 minutes. We have been regularly doing checkups and all other parameters are normal.
Although now a days she feels lethargic.

Need your help on how to go ahead on this. What tests can be done to diagnose the root cause. What can be the probable root cause. Are medicines prescribed by doctor ( Zilarbi 80 morning and prolomet xl 25 evening) adequate?

Thanks in advance.
Answered by Dr. Bhanu Partap 27 minutes later
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:
Hello Sir

After going through the medical details provided by you i understand your concern and i would like to tell you that blood pressure control should be a Holistic approach rather than just depending upon medicines.

Holistic approach is basically a combination of Medicines and life style modifications.

Lifestyle modifications includes:
1. Daily morning walks for atleast 5 days a week.
2. Very low dietary salt intake
3. Avoiding intake of coffee or other caffiene containing drinks
4. Eating good amount of fresh fruits and vegetables daily.
5. Good water intake
6. Yoga/Meditation is possible is helpful

Having a normal angio report is good. TMT of 3 minutes indicate poor effort tolerance which means either she is overweight or she is not physically active.

I would like to suggest you to get her ECHO done and along with that few blood tests like
1. Thyroid profile
2. CBC
3. Serum Electrolytes
4. KFT

I hope this information will be helpful.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Bhanu Partap 7 hours later
Sir thanks for the revert.

Holistic approach will surely help in long term. But what’s the approach for immediate future ?
Are the medicines I mentioned adequate or needs to be changed ?

Echo and all blood tests have been normal and have been done every six months.

My mother is physically active. So we are clueless as of now. Are we ignoring something big ?

Answered by Dr. Bhanu Partap 32 minutes later
Brief Answer:
Hello Again

Detailed Answer:
Few points among the point mentioned do havr immediate benefit also for bo reduction like Reducing the dietary salt intake and avoiding caffeine containing drinks like coffee.

Have you noticed like at what time the spikes are more common in morning or in evening and how frequently they are happening ?? Now this is important as it will help us decide which medicine needs to be altered.

Kindly revert with the required details.

Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Bhanu Partap 14 minutes later
Hello Sir

Mother is taking two medicines one at 12 pm and another 8 pm and spike happens 4 hours after taking medicine. So observed spike is at around 4 pm and at 9 am . Salt intake is moderate and we will lower it further.

Answered by Dr. Bhanu Partap 1 hour later
Brief Answer:
Hello Again

Detailed Answer:
In my opinion we can try substituting Zilarbi with Telma Am (40/5 mg) in the morning and continue with Met Xl in evening.

But it's advisable to consult your doctor personally regarding this.

Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Prasad
Answered by
Dr. Bhanu Partap


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