Blood Pressure Concerns: Insights from a Cardiovascular Specialist - Cardiology

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Blood pressure issues?


Hello Dr.
Wu: I previously had premature ventricular contractions and was taking antiarrhythmic medication, but I haven't taken it for 2-3 years.
My family has a history of hypertension, and I don't usually check my blood pressure.
However, three days ago, I measured it and found it to be 143/95 with a heart rate of 101.
I have been experiencing left back pain and poor sleep, so my doctor prescribed a muscle relaxant for me.
I also had blood drawn that day.
The next morning, my blood pressure was 139/92 with a heart rate of 95.
Despite taking the medication, my heart rate remained fast, and I continued to have trouble sleeping, so I consulted a psychiatrist.
Due to my previous sleep issues and anxiety, the doctor prescribed me lorazepam and escitalopram along with the antiarrhythmic medication.
Over the past two days, I have measured my blood pressure in the morning and evening, with systolic readings ranging from a high of 142 to a low of 132, and diastolic readings from a high of 95 to a low of 85.
My heart rate ranged from a high of 95 to a low of 82.
I also reviewed my blood test results, which showed total cholesterol at 157, triglycerides at 162, HDL at 44, and LDL at 100.
The doctor mentioned that based on my blood pressure readings over the past two days, I do not need to start medication yet, but I am worried that having hypertension without medication could lead to problems.
Thank you!

Miss Yan, 30~39 year old female. Ask Date: 2021/06/21

Dr. Wu Xueming reply Cardiology


It is recommended to maintain a regular lifestyle, engage in regular exercise, and follow a light diet.
However, if blood pressure remains consistently above 140/90, it is advisable to seek medical attention and consider starting antihypertensive medication.

Reply Date: 2021/06/21

More Info


Hello, thank you for sharing your concerns regarding your blood pressure and overall cardiovascular health. Based on the information you've provided, it seems that you are experiencing elevated blood pressure readings, which can be a cause for concern, especially given your family history of hypertension. Let’s break down your situation and discuss the implications of your blood pressure readings, heart rate, and the steps you might consider moving forward.

Firstly, your blood pressure readings of 143/95 and 139/92 indicate that you are in the stage of hypertension, specifically Stage 1 hypertension according to the American Heart Association's guidelines. Hypertension is a significant risk factor for cardiovascular diseases, including heart attack and stroke. The systolic pressure (the first number) represents the pressure in your arteries when your heart beats, while the diastolic pressure (the second number) indicates the pressure when your heart is at rest between beats. A reading of 140/90 mmHg or higher is classified as hypertension.

Your heart rate, which has been recorded between 82 and 101 beats per minute, is also noteworthy. A resting heart rate above 100 beats per minute is termed tachycardia and can be influenced by various factors, including anxiety, stress, medications, or underlying health conditions. Given that you have experienced anxiety and sleep disturbances, these could be contributing to your elevated heart rate.

The presence of left back pain and difficulty sleeping may also be related to your anxiety and stress levels. Chronic stress can lead to increased blood pressure and heart rate, creating a cycle that can be difficult to break. It's essential to address both the physical and psychological aspects of your health. The muscle relaxants and medications prescribed by your doctor may help alleviate some of your discomfort, but managing stress and anxiety through relaxation techniques, therapy, or lifestyle changes can also be beneficial.

Regarding your cholesterol levels, your total cholesterol of 157 mg/dL is within a desirable range, but your triglycerides at 162 mg/dL are slightly elevated. The HDL (good cholesterol) at 44 mg/dL is on the lower side, while your LDL (bad cholesterol) at 100 mg/dL is acceptable but could be improved. Lifestyle modifications, including a heart-healthy diet, regular physical activity, and weight management, can help improve your lipid profile and overall cardiovascular health.

Your doctor’s recommendation to monitor your blood pressure without immediate medication is not uncommon, especially if your readings are not consistently high and if there are no other significant risk factors or symptoms present. However, it is crucial to maintain regular monitoring of your blood pressure at home and keep track of any changes. If your blood pressure remains elevated or if you experience any new symptoms, it would be wise to follow up with your healthcare provider for further evaluation.

In summary, while your current blood pressure readings are concerning, there are several steps you can take to manage your health proactively. These include:
1. Regular Monitoring: Keep a log of your blood pressure readings and heart rate to share with your doctor.

2. Lifestyle Changes: Focus on a balanced diet low in sodium and saturated fats, engage in regular physical activity, and maintain a healthy weight.

3. Stress Management: Consider relaxation techniques such as yoga, meditation, or counseling to help manage anxiety and improve sleep quality.

4. Follow-Up Care: Stay in touch with your healthcare provider, especially if your blood pressure does not improve or if you have new symptoms.

By taking these steps, you can better manage your blood pressure and reduce your risk of cardiovascular complications. Always consult your healthcare provider before making any significant changes to your treatment plan. Thank you for reaching out, and I wish you the best in your health journey!

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