High Blood Pressure: A Young Adult's Journey to Wellness

Regarding blood pressure issues?

I recently graduated from university, and during my college years, my lifestyle was irregular (staying up all night or sleeping late), and my eating habits were inconsistent, often missing meals.
However, I maintained a routine of exercising for two hours every day.
A few weeks ago, while working out at the gym, I suddenly experienced a thunderclap headache during a squat, prompting me to seek consultation from a neurologist, and I immediately stopped my exercise regimen.
A CT scan of my brain was performed, and the results were normal.
However, my blood pressure readings were abnormal, consistently measuring 150-160 (with diastolic pressure being normal, but my heart rate spiked to 130 at times).
The doctor prescribed me a chronic antihypertensive medication.
After taking the first dose, I consulted a family physician near my home, who advised me to stop the medication for a while and monitor my blood pressure at home.
Although my readings at home were still somewhat elevated, averaging around 130-145 (with an average of 139), I noticed that I would feel anxious each time I measured it (I had previously been on anti-anxiety medication).
My heart rate ranged from 90 to 110, likely due to anxiety, and I am unsure why I feel this way.

I would like to know if I still need to take medication for hypertension, considering I am aware that I have some symptoms.
Also, I want to ask if the measurements I took 12, 24, and 36 hours after taking the first dose of the medication (Norvasc) reflect my blood pressure levels without medication.
Additionally, since that episode of headache, I have been experiencing a sensation of tightness in my neck and a feeling of pressure in my head, although my mood has improved at times.
I am still aware that my blood pressure remains elevated, despite exercising regularly.
However, my weight has exceeded 100 kg, and my cholesterol levels are high.
I apologize for asking so many questions and hope the doctor can clarify these concerns for me.
Thank you.

edw, 20~29 year old female. Ask Date: 2020/06/28

Dr. He Dongjin reply Cardiology

Hello, feeling anxious can affect your blood pressure readings, making them inaccurate.
It's uncertain whether you have hypertension or not.
Here are three methods for blood pressure management:
1.
Medication: You don't need to rush into taking medication right away.
2.
Lifestyle adjustments: Focus on maintaining a regular schedule, controlling your weight, and increasing your physical activity, such as brisk walking and other aerobic exercises.
3.
Dietary adjustments: Reduce oil and salt intake.
Prioritize lifestyle and dietary changes first, and there's no need to measure your blood pressure immediately.
You can reassess it after some time.
Changhua Hospital cares about your well-being.

Reply Date: 2020/06/28

More Info

Understanding high blood pressure, especially in young adults, is crucial for maintaining overall health and preventing long-term complications. Your situation reflects a common concern among young adults who may experience elevated blood pressure due to lifestyle factors, stress, and other health conditions.

Firstly, it’s important to recognize that high blood pressure, or hypertension, can be influenced by various factors, including diet, exercise, stress, and sleep patterns. In your case, you mentioned irregular sleep habits and inconsistent eating patterns during your college years, which can significantly impact blood pressure. Lack of sleep and poor nutrition can lead to increased stress hormones in the body, which may elevate blood pressure levels.

The sudden onset of a severe headache during exercise, especially if it felt like a "thunderclap," is concerning and warrants immediate medical attention, as you did. The fact that your brain scans returned normal is reassuring, but it’s essential to continue monitoring your symptoms and blood pressure. Your recorded blood pressure readings of 150-160 mmHg are indeed high, especially for someone your age. The American Heart Association defines hypertension as a systolic blood pressure of 130 mmHg or higher, or a diastolic blood pressure of 80 mmHg or higher.

Regarding your question about medication, it’s understandable to feel apprehensive about starting a new treatment. The initial prescription for antihypertensive medication (like Norvasc, which you mentioned) is often a precautionary measure to manage high blood pressure and reduce the risk of cardiovascular events. However, if you are experiencing anxiety that affects your blood pressure readings, it may be beneficial to address this anxiety first. Stress and anxiety can lead to temporary spikes in blood pressure, and it’s common for individuals to feel nervous when measuring their blood pressure, which can further skew results.

You mentioned that your home readings are still elevated, averaging around 139 mmHg. It’s crucial to measure your blood pressure in a calm environment, ideally at the same time each day, and under similar conditions to get the most accurate readings. If you find that your blood pressure remains consistently high despite lifestyle changes, medication may be necessary.

In terms of lifestyle modifications, there are several strategies you can implement to help manage your blood pressure:
1. Diet: Focus on a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. The DASH (Dietary Approaches to Stop Hypertension) diet is particularly effective for lowering blood pressure. Limit your intake of sodium, saturated fats, and sugars.

2. Exercise: While you are already exercising for two hours daily, ensure that your routine includes a mix of aerobic exercises (like walking, running, or cycling) and strength training. Regular physical activity can help lower blood pressure and improve heart health.

3. Sleep: Aim for 7-9 hours of quality sleep each night. Establish a regular sleep schedule and create a relaxing bedtime routine to improve your sleep quality.

4. Stress Management: Incorporate stress-reducing techniques such as mindfulness, meditation, or yoga into your daily routine. These practices can help lower blood pressure and improve overall well-being.

5. Regular Monitoring: Keep track of your blood pressure readings at home and share them with your healthcare provider. This will help them assess your condition and make informed decisions about your treatment plan.

6. Weight Management: Since you mentioned being over 100 kg, focusing on weight loss through a combination of diet and exercise can significantly impact your blood pressure.

Lastly, if you continue to experience symptoms like headaches or neck tension, it’s essential to discuss these with your healthcare provider. They may refer you to a specialist or suggest further evaluation to rule out any underlying conditions.

In conclusion, while your blood pressure readings are concerning, there are many proactive steps you can take to manage your health. Regular follow-ups with your healthcare provider, combined with lifestyle changes, can lead to significant improvements in your blood pressure and overall health. Always communicate openly with your healthcare team about your concerns and symptoms, as they can provide personalized guidance tailored to your situation.

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