Hypertension: Managing Blood Pressure and Cholesterol Levels

Hypertension screening?

Hello doctor, I'm 33 years old, 167 cm tall, and weigh 85 kg.
Last year during my health check-up, my blood pressure was high at 145/92 and my heart rate was 88, which I think might have been due to nerves.
Since I didn't feel any particular symptoms in my daily life, I didn't pay much attention to it.
However, a week before this year's health check-up, I was worried about having high numbers again, so I started exercising daily, eating lighter meals, and taking a health supplement recommended by a friend, which is a bitter melon tablet and Q10.
Recently, when I measure my blood pressure in the morning, the systolic pressure ranges from 122 to 137 and the diastolic pressure is between 70 and 88.
I take the bitter melon and Q10 tablets after measuring my blood pressure.
I would like to know if I am considered to have hypertension.
During my health check-up, my blood pressure was 134/76, total cholesterol was 211, triglycerides were 94, low-density lipoprotein (LDL) was 147, fasting blood glucose was 88, GPT was 20, and creatinine was 0.9.
Given that I have been exercising and taking supplements, are my blood pressure readings inaccurate? Do I actually have hypertension? If I lower my cholesterol and LDL levels, will my blood pressure return to normal, below 120?

gary, 30~39 year old female. Ask Date: 2017/07/08

Dr. Chen Taicheng reply Family Medicine

● Normal blood pressure is defined as ≤120/80 mmHg; hypertension is defined as ≥140/90 mmHg.
However, blood pressure can sometimes be elevated due to anxiety during a clinic visit, so it is best to measure blood pressure at home, which should be the primary reference.
If home blood pressure readings are ≥135/85 mmHg, this is also considered hypertension.
When measuring blood pressure, you should sit and rest for 5-10 minutes without eating, drinking coffee, or engaging in other activities.
If your blood pressure exceeds this value first thing in the morning without any prior activity, it indicates hypertension.
● Your BMI is 30.4, which classifies you as obese, making it easier for blood pressure to rise (normal BMI is approximately 18-24; BMI ≥27 is considered obese).
Total cholesterol and low-density lipoprotein (LDL) cholesterol are slightly elevated; hyperlipidemia is related to weight, genetics, exercise, alcohol consumption, or certain medications.
● The primary methods for lowering lipid levels should focus on your exercise habits and weight management, with dietary factors being less significant (approximately 80% of cholesterol is produced by the body, such as the liver, with only about 20% coming from food).
If you cannot control your levels after 3-6 months, then consider medication treatment.
● If bitter melon tablets and Coenzyme Q10 are effective, you may consider using them; if not, it is fine to discontinue.
● You are still young, and with active exercise, lifestyle adjustments, and dietary moderation, you should be able to manage hypertension and hyperlipidemia.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department cares about you.

Reply Date: 2017/07/08

More Info

Managing hypertension and cholesterol levels is crucial for maintaining overall cardiovascular health, especially for someone like you, who is 33 years old and has experienced fluctuations in blood pressure readings. Let's break down your situation and provide some insights.

Understanding Blood Pressure Readings
Your previous blood pressure reading of 145/92 mmHg indicates stage 1 hypertension, as the systolic (top number) is above 140 and the diastolic (bottom number) is above 90. However, your recent readings, including the one taken during your check-up (134/76 mmHg), fall within the normal range, particularly the diastolic reading, which is below 80 mmHg. The American Heart Association defines normal blood pressure as anything below 120/80 mmHg, while elevated blood pressure is defined as systolic readings between 120-129 mmHg and diastolic readings below 80 mmHg.

Factors Influencing Blood Pressure
1. Anxiety and Stress: It’s common for individuals to experience elevated blood pressure readings in clinical settings due to anxiety or stress. This phenomenon is often referred to as "white coat syndrome." Your concern about getting high readings may have contributed to your anxiety, which can temporarily raise blood pressure.

2. Lifestyle Changes: You mentioned that you have started exercising regularly and eating a healthier diet. These lifestyle modifications can significantly impact blood pressure. Regular physical activity helps strengthen the heart, allowing it to pump blood more efficiently, which can lower blood pressure. A diet low in sodium and rich in fruits, vegetables, and whole grains can also contribute to better blood pressure control.

3. Supplements: The use of supplements like bitter melon and Coenzyme Q10 (Q10) may have some benefits for blood pressure management, although the evidence is mixed. While some studies suggest that CoQ10 may help lower blood pressure, more research is needed to establish its effectiveness. Bitter melon is often touted for its potential health benefits, but its impact on blood pressure can vary from person to person.

Cholesterol Levels
Your cholesterol levels show a total cholesterol of 211 mg/dL, which is borderline high (optimal is below 200 mg/dL). Your low-density lipoprotein (LDL) cholesterol is at 147 mg/dL, which is considered high. High LDL cholesterol can contribute to the development of atherosclerosis, increasing the risk of heart disease and stroke.

1. Impact of Cholesterol on Blood Pressure: While cholesterol itself does not directly cause high blood pressure, high levels of LDL cholesterol can lead to the hardening and narrowing of arteries (atherosclerosis), which can increase blood pressure over time. Therefore, managing cholesterol levels is essential for overall cardiovascular health.

2. Dietary Adjustments: To lower your cholesterol levels, consider incorporating more fiber-rich foods, such as oats, beans, lentils, fruits, and vegetables, into your diet. Foods rich in omega-3 fatty acids (like fish) and healthy fats (like avocados and nuts) can also help improve your lipid profile.

Conclusion and Recommendations
Based on your current situation, it appears that you are making positive strides in managing your blood pressure and cholesterol levels through lifestyle changes. Your recent blood pressure readings suggest that you may not have sustained high blood pressure, especially if you continue to monitor it regularly and maintain your healthy habits.

1. Continue Monitoring: Keep tracking your blood pressure at home, but try to do so in a relaxed environment to avoid anxiety-induced spikes. Aim for readings at the same time each day for consistency.

2. Regular Check-ups: Maintain regular appointments with your healthcare provider to monitor your blood pressure and cholesterol levels. They can provide personalized advice and adjust any treatment plans as necessary.

3. Healthy Lifestyle: Continue your exercise regimen and healthy eating habits. Consider discussing your supplement use with your healthcare provider to ensure they are appropriate for you.

4. Stress Management: Explore stress-reduction techniques such as mindfulness, yoga, or meditation, which can help lower blood pressure and improve overall well-being.

By staying proactive about your health, you can effectively manage your blood pressure and cholesterol levels, reducing the risk of future cardiovascular issues.

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