Hypertension: When to Seek Treatment and Medication Options

Q: Hypertension: When to Seek Treatment and Medication Options

Hello： The medication you are currently taking is a type of beta-blocker, and the previously used medications, Concor and Inderal, are also beta-blockers. <br>For pregnant women, among various cardiovascular medications, the selection of beta-blockers is relatively safe. <br>Sinc

Hypertension

Hello: The general definition of hypertension is a systolic blood pressure of 140 mmHg or higher and/or a diastolic blood pressure of 90 mmHg or higher.
Some doctors define hypertension as a systolic blood pressure of 160 mmHg or higher and/or a diastolic blood pressure of 95 mmHg or higher in adults.
My blood pressure upon waking is between 146-155 systolic and 95-110 diastolic.
Once or twice a week, my blood pressure suddenly spikes to 160-204 systolic and 110-122 diastolic, sometimes before bed, sometimes during sleep, and sometimes while at work (without any specific triggers).
Does this count as hypertension? Why is it that when I visited cardiologists at two different hospitals, one doctor said it was fine and prescribed no medication, while another prescribed antihypertensive medication? I have taken Concor and Inderal, but both made me feel very uncomfortable.
This time, the doctor prescribed Sectral, and I take 1/4 tablet after breakfast, which keeps my blood pressure below 140/90 (a B-class medication, as I hope to conceive soon), but I still feel uncomfortable.
Should I consider changing my medication? P.S.
I have had an echocardiogram that showed mild mitral valve prolapse, and my ECG was normal.
I often experience dizziness, palpitations, frequent urination, numbness in my hands and feet, tinnitus, and sometimes insomnia.
Doctor, should I take medication? Is there a more suitable medication for me (that is safe for pregnancy)? Thank you.

vivian, 30~39 year old female. Ask Date: 2008/09/04

Dr. Lin Jixiong reply Cardiology

Hello: The medication you are currently taking is a type of beta-blocker, and the previously used medications, Concor and Inderal, are also beta-blockers.
For pregnant women, among various cardiovascular medications, the selection of beta-blockers is relatively safe.
Sincerely, Dr.
Lin Chi-Hsiung, Taoyuan General Hospital.

Reply Date: 2008/09/04

More Info

Hypertension, or high blood pressure, is a common condition that can lead to serious health issues if left untreated. The general definition of hypertension is a consistent blood pressure reading of 140/90 mmHg or higher. However, some healthcare professionals may use different thresholds, such as 160/95 mmHg, to define hypertension, particularly in specific populations or clinical settings.
Based on your description, your blood pressure readings of 146-155 systolic and 95-110 diastolic indicate that you are indeed experiencing hypertension. The occasional spikes to 160-204 systolic and 110-122 diastolic, especially if they occur without any apparent triggers, are concerning and warrant further evaluation and management.
It is essential to understand that hypertension can be classified into two categories: primary (essential) hypertension, which has no identifiable cause, and secondary hypertension, which is due to an underlying condition such as kidney disease or hormonal disorders. Given your symptoms, including dizziness, palpitations, and other discomforts, it is crucial to work closely with your healthcare provider to determine the underlying cause of your hypertension and to develop an appropriate treatment plan.

Regarding medication, it is common for patients to experience side effects when starting antihypertensive medications. The medications you mentioned, such as Inderal (propranolol) and Sectral (acebutolol), are beta-blockers that can help lower blood pressure but may cause side effects like fatigue, dizziness, or gastrointestinal discomfort. If you are experiencing significant discomfort with your current medication, it is essential to communicate this with your doctor. They may consider adjusting your dosage or switching you to a different class of antihypertensive medication that may be better tolerated.

For women who are planning to become pregnant, it is crucial to choose antihypertensive medications that are safe during pregnancy. Some medications, such as certain beta-blockers and ACE inhibitors, may not be recommended during pregnancy due to potential risks to the fetus. Your healthcare provider can help you navigate these options and find a medication that effectively manages your blood pressure while minimizing risks.

In addition to medication, lifestyle modifications play a vital role in managing hypertension. These include:
1. Diet: Following a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, and lean proteins while reducing sodium intake, can significantly impact blood pressure.

2. Exercise: Regular physical activity can help lower blood pressure and improve overall cardiovascular health. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week.

3. Weight Management: Maintaining a healthy weight is crucial for managing blood pressure. Even a modest weight loss can have a positive effect.

4. Stress Management: Techniques such as mindfulness, meditation, and yoga can help reduce stress, which may contribute to elevated blood pressure.

5. Regular Monitoring: Keeping track of your blood pressure at home can help you and your healthcare provider assess the effectiveness of your treatment plan and make necessary adjustments.

In conclusion, your blood pressure readings indicate that you are experiencing hypertension, and it is essential to work closely with your healthcare provider to determine the best course of action. This may involve medication adjustments, lifestyle changes, and regular monitoring to ensure that your blood pressure is well-controlled. If you have concerns about specific medications, especially in relation to pregnancy, do not hesitate to discuss these with your doctor to find a suitable and effective treatment plan.

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