Managing Hypertension and Other Three Highs: When to See a Specialist?

Three high issues (Hypertension, Hyperglycemia, Hyper

Hello Doctor: Recently, during a routine health check for adults, I discovered issues related to the "three highs" (hypertension, hyperlipidemia, and hyperglycemia), particularly with consistently elevated blood pressure.
I measured my morning blood pressure over two weeks, and the results ranged between 160/90 and 138/80, with a pulse rate of 79 to 80.
My family medicine physician prescribed Olmetec 20mg, to be taken once daily, and I have been taking it for three weeks, but it seems to have no effect.
I would like to ask the doctor: 1.
Should I continue treatment in family medicine for the "three highs," or should I seek treatment from specialized departments? 2.
If I need to see specialists, which departments should I consult? Thank you, Doctor.

LKK, 60~69 year old female. Ask Date: 2019/05/28

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, issues related to the three highs (hypertension, hyperlipidemia, and hyperglycemia) should be suitable for treatment in family medicine.
If your family physician believes your condition is unstable, they will likely refer you to the appropriate specialists in a timely manner.
It is recommended that you monitor your blood pressure in the morning and evening, avoiding measurements after meals, when you need to urinate, or after exercise.
Try to measure your blood pressure in a quiet environment and a calm state of mind.
If you obtain a high reading, please rest for about 15 minutes before measuring again.
You can refer to "Timing for Blood Pressure Measurement | Hypertension for the Three Highs" (http://www.havemary.com/article.php?id=4825).
Please share your blood pressure records with your physician to adjust your medication accordingly.
Thank you for your inquiry!

Reply Date: 2019/05/28

More Info

Managing hypertension and other related health issues, often referred to as the "three highs" (high blood pressure, high cholesterol, and high blood sugar), requires a comprehensive approach. Given your recent health check-up indicating persistent hypertension, it is crucial to understand when to seek specialized care and how to manage your condition effectively.

Understanding Hypertension
Hypertension, or high blood pressure, is a condition that can lead to serious health problems, including heart disease, stroke, and kidney damage. Your recorded blood pressure readings of 160/90 and 138/80 indicate that you are experiencing elevated blood pressure levels. The American Heart Association classifies blood pressure readings of 130-139 systolic or 80-89 diastolic as Stage 1 hypertension, while readings of 140/90 or higher are classified as Stage 2 hypertension.

Medication Management
You mentioned that you have been prescribed Olmetec (Olmesartan) 20 mg daily for three weeks, but you have not noticed significant improvements. It is essential to give any antihypertensive medication some time to take effect, as it may take several weeks to see the full benefits. However, if you continue to experience high blood pressure readings, it is crucial to follow up with your healthcare provider. They may need to adjust your medication dosage or consider adding another medication to your regimen.

When to See a Specialist
1. Persistent High Blood Pressure: If your blood pressure remains consistently high despite medication, it is advisable to consult a cardiologist or a hypertension specialist. They can conduct a thorough evaluation, including potential secondary causes of hypertension, such as hormonal imbalances or kidney issues.

2. Presence of Other Conditions: If you have other health issues related to the "three highs," such as elevated cholesterol levels or blood sugar levels, it may be beneficial to see an endocrinologist or a cardiologist. These specialists can provide targeted treatment plans for managing cholesterol and glucose levels alongside hypertension.

3. Lifestyle Factors: If lifestyle modifications (diet, exercise, stress management) are not yielding results, a nutritionist or a dietitian can help create a personalized plan that addresses your specific needs and challenges.

Recommended Specialists
- Cardiologist: For comprehensive management of hypertension and cardiovascular health.

- Endocrinologist: If you have issues with blood sugar or cholesterol that require specialized attention.

- Dietitian/Nutritionist: For dietary advice tailored to managing hypertension and other metabolic conditions.

- Nephrologist: If there are concerns about kidney function, which can impact blood pressure.

Conclusion
In summary, managing hypertension and the associated "three highs" is a multifaceted process that may require the involvement of various specialists. It is essential to communicate openly with your primary care physician about your concerns and the effectiveness of your current treatment plan. If your blood pressure remains high or if you experience any new symptoms, do not hesitate to seek specialized care. Regular monitoring, lifestyle changes, and appropriate medical management are key to controlling hypertension and reducing the risk of complications. Remember, proactive management is crucial in maintaining your overall health and well-being.

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