Elevated Blood Pressure: When to See a Cardiologist

Hypertension

Hello, Doctor He: I have mild ventricular premature contractions, and my usual heart rate is between 58-62 beats per minute.
My blood pressure has been around 60-90 for decades.
Recently, my blood pressure has risen to 139-89.
My face often feels warm, and I have a slight headache along with tinnitus.
An ENT doctor prescribed me Propanolol.
I frequently experience mild soreness in my chest area, which sometimes radiates to my back and armpit.
I would like to ask you a few questions: 1.
Do I need to see a cardiologist? 2.
How long should I take Propanolol before I can stop? 3.
Is there a connection to my sudden increase in blood pressure? Is my blood too thick or is my cholesterol too high? Am I at risk of having a stroke? I apologize for bothering you with these questions during your busy schedule.
Thank you for your help.

dasi, 50~59 year old female. Ask Date: 2018/03/13

Dr. He Dongjin reply Cardiology

Hello, a blood pressure reading of 139/89 does not necessarily indicate hypertension, and it may not be related to blood pressure.
I have reservations about taking medication like Pulse Care, which is why I haven't taken it for long.
The heart pain extending to the armpit and back needs further investigation.
I recommend visiting a cardiology clinic for a more thorough examination.
It's normal for blood pressure to fluctuate when one feels unwell.
We should first observe if the blood is too thick or if cholesterol levels are too high; this should not be related to water pressure or water quality, and it won't lead to a stroke.
Please do not worry too much.
Take care, and this is from Changhua Hospital.

Reply Date: 2018/03/13

More Info

Understanding elevated blood pressure and its implications for cardiovascular health is crucial, especially when symptoms such as palpitations, discomfort, and changes in blood pressure readings arise. Based on your description, it seems you are experiencing a combination of symptoms that warrant further evaluation by a cardiologist.

1. Should you see a cardiologist?
Given your history of premature ventricular contractions (PVCs), recent elevation in blood pressure to 139/89 mmHg, and accompanying symptoms such as facial flushing, head pressure, tinnitus, and chest discomfort, it is advisable to consult a cardiologist. While your baseline heart rate is relatively low (58-62 bpm), the sudden increase in blood pressure and the presence of discomfort could indicate underlying cardiovascular issues that need to be assessed. A cardiologist can perform a thorough evaluation, including an electrocardiogram (EKG), echocardiogram, and possibly a stress test to determine the health of your heart and the significance of the PVCs.

2. Duration of medication (脈優)
The medication you mentioned, likely a beta-blocker or similar, is often prescribed to manage symptoms associated with PVCs and to help control heart rate and blood pressure. The duration for which you should continue this medication depends on your specific condition and how well your symptoms are managed. It is essential to follow your healthcare provider's recommendations regarding the duration of treatment. Regular follow-ups will help determine if the medication can be reduced or discontinued based on your symptomatology and blood pressure readings.

3. Implications of sudden blood pressure increase
The increase in your blood pressure could be related to various factors, including stress, changes in physical activity, dietary habits, or even medication side effects. Elevated blood pressure can indeed increase the risk of cardiovascular events, including stroke, especially if it is sustained over time. It is essential to monitor your blood pressure regularly and maintain a healthy lifestyle, including a balanced diet low in saturated fats and cholesterol, regular physical activity, and stress management techniques.

Regarding your concerns about blood viscosity and cholesterol levels, it is advisable to have a lipid panel done to assess your cholesterol levels, including total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. High cholesterol can contribute to the development of atherosclerosis, which increases the risk of cardiovascular events. If your cholesterol levels are elevated, your healthcare provider may recommend lifestyle modifications and possibly medication to manage it.

In summary, your symptoms and recent changes in blood pressure suggest that a visit to a cardiologist is warranted. They can provide a comprehensive evaluation and guide you on the appropriate management of your symptoms and blood pressure. It is crucial to address these concerns proactively to reduce the risk of potential cardiovascular complications. Remember, it is always better to err on the side of caution when it comes to heart health.

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