Managing Hypertension and Chest Discomfort: Key Insights for Patients

Q: Managing Hypertension and Chest Discomfort: Key Insights for Patients

Hello： 1. <br>Long-term medication may still be necessary unless blood pressure is too low. <br>2. <br>Please consult a cardiologist first to determine whether it is related to the heart or a muscle strain.

Hypertension and chest tightness issues?

1.
Three years ago, my blood pressure was over 150/100.
After starting medication, it has been more stable and usually ranges between 120-135/70-85.
I have tried not taking the medication for two days, and my blood pressure remained stable.
Should I continue taking the medication daily as my outpatient physician advised, or can I only take it when my blood pressure exceeds the normal range?
2.
In recent weeks, I have noticed that in the morning, right after waking up in bed, I experience a dull and slightly sharp pain in my left chest that coincides with my breathing, especially when I sleep on my right side.
However, after a while or once I get up and warm up, the sensation gradually decreases and disappears.
My annual health check-ups, aside from blood pressure and cholesterol, have shown no abnormalities.
What are your thoughts on this symptom? Thank you!

Mr. Wu, 50~59 year old female. Ask Date: 2016/04/03

Dr. Zhou Ziguang reply Pulmonology

Hello: 1.
Long-term medication may still be necessary unless blood pressure is too low.
2.
Please consult a cardiologist first to determine whether it is related to the heart or a muscle strain.

Reply Date: 2016/04/03

More Info

Managing hypertension and chest discomfort is crucial for maintaining overall cardiovascular health. Based on your situation, let's address your concerns regarding blood pressure management and the chest discomfort you are experiencing.

1. Hypertension Management: You mentioned that three years ago your blood pressure exceeded 150/100 mmHg, and since starting medication, your readings have stabilized between 120-135/70-85 mmHg. This is a commendable achievement, as maintaining blood pressure within the normal range significantly reduces the risk of cardiovascular events such as heart attacks and strokes.
Your question about whether to continue daily medication or only take it when your blood pressure spikes is important. The general recommendation for managing hypertension is to adhere to a prescribed medication regimen consistently. Hypertension is often a chronic condition that requires ongoing management. Even if your blood pressure readings are stable, discontinuing medication can lead to fluctuations and potential spikes in blood pressure, which can be harmful. It is essential to follow your healthcare provider's advice regarding medication adherence. If you have concerns about side effects or the need for medication, discuss these with your doctor, who may consider adjusting your treatment plan.

2. Chest Discomfort: The discomfort you describe—specifically, a dull ache and slight pain in the left chest upon waking, particularly when sleeping on your right side—warrants attention. While it is common for individuals to experience musculoskeletal pain or discomfort due to sleeping positions or muscle strain, it is essential to rule out any cardiac-related issues, especially given your history of hypertension.

The fact that the discomfort subsides after a while or with movement is somewhat reassuring, as it may indicate that the pain is not directly related to the heart. However, it is crucial to consider other factors that could contribute to your symptoms. For instance, anxiety, stress, or even gastroesophageal reflux disease (GERD) can manifest as chest discomfort.
Given your history of hypertension and the nature of your symptoms, it would be prudent to consult with your healthcare provider. They may recommend further evaluation, such as an electrocardiogram (ECG) or echocardiogram, to assess your heart's function and rule out any underlying cardiac issues. Additionally, they may suggest lifestyle modifications, such as stress management techniques, dietary changes, or exercise, which can help alleviate both hypertension and chest discomfort.

In summary, it is vital to continue your antihypertensive medication as prescribed and to monitor your blood pressure regularly. Regarding your chest discomfort, seek medical advice to ensure that it is not related to any serious underlying condition. Regular follow-ups with your healthcare provider will help you manage your hypertension effectively and address any new symptoms that may arise. Remember, proactive management is key to maintaining cardiovascular health and overall well-being.

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