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Dr. Andrew Rynne

Family Physician

Exp 50 years

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30 years old male having hypertension and EXTREME pulse pressure

Fit 30 yr old male with hypertension and EXTREME pulse pressure - need specialist? Hi, i am a fit 30 year old non smoker with a low resting pulse of 40 bpm, with an average pulse of 58 across all BP measurements, but i have been diagnosed with essential hypertension by my GP. I have been home monitoring my BP for a few months now - Prior to medication, my BP was 150/81 (n= 41, over 7 days). Taking Coversyl 10 mg only reduced it to 143/77 (n =116, over 45 days). I then tried Coversyl Plus (5mg/1.25 mg), which had even less of an effect (148/80, n = 42 over 17 days). I have now been on Coversyl 10 mg and 1.5 mg indapamide for 5 days (140/72, n =22), and it is having more of an effect, although it appears to drop my diastolic very low when resting - I ve had supine measurements (watching the tour de france!) of 146/58. Hence, i am worried about my pulse pressure - my diastolic is low, but my systolic is still high - my average pulse pressure over all this time is 66, with a max of 101 and a min of only 48). Should i see a cardiologist? Cheers all - some extra notes - I m not worried about my low resting pulse - I m proud of it ;) I included it as an indication of my fitness level (yes, i have always exercised regularly). Neither parent suffers from high BP. Re: paramedic - from what i can see in the literature, the vogue now seems to be emphasise MAP or mean arterial pressure [MAP = (sys* 1/3 + dia * 2/3) ]- which provides a better estimate of the total stress your organs are under than either the systolic or diastolic alone. If you use MAP as an indicator, i do have mild hypertension, and i do agree with my GP that in my case (physically fit, non-smoker with no genetic history and only 30 years of age) that is somewhat unusual, and probably deserves treatment. I think i will take your advice and get a referall to a specialist though - I m a little worried about her seeming lack of expertise in the area.
Sun, 20 Dec 2009
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I would advise to go see a new GP before he kills you. I'm surprised your on medication when your BP is not that high. Your BP is fine although a little on the high side or normal. Hypertension is usually classed as anything over 140/90 with the diastolic being the key factor. I wouldn't be too concerned with the pulse pressure and the low hate rate as yo have stated that you are a young fit non smoker and i would assume you exercise a lot, and if you do its normal for fit athletic type people to have a low pulse rate at rest. Thanks for the feed back and I really think you need a new GP. Just looking now at your Pulse Pressure and even your MAP there is still nothing that would indicate the need to be on meds or need to see a cardiologist. Having a Pulse pressure of 58 is good. It just means your body is being well perfused. Stupid Doctors they even call us for help most days. Just a quick note we work out our MAP by Dia BP + (1/3 Pulse pressure) and your Pulse
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