Unexplained Hypertension in Young Adults: A Medical Perspective

Young people with unexplained hypertension?

Hello, Doctor Lai.
I take medication for schizophrenia every day, and I am not on any other medications (I have been on this medication for about nine years).
This week, I had my blood pressure and pulse checked at the hospital.
The first measurement was (146 mmHg/89 mmHg, 120 bpm), and ten minutes later, the second measurement (around 2:30 PM) was (149 mmHg/92 mmHg, 121 bpm).
Three days later, the third measurement (at 11 AM) was (133 mmHg/96 mmHg, 120 bpm).
I weigh 70 kg and am 166 cm tall.
I have amblyopia and myopia in my left eye and myopia in my right eye.
I have never smoked or consumed alcohol, and I haven't had coffee in a long time (about six months).
I occasionally drink tea, have milk or yogurt once a week, and often drink juice, but I eat very little fruit.
I usually have vegetables and meat with almost every meal, and sometimes take fish oil (one capsule a day as my mother suggested).
However, I often experience constipation, usually having a bowel movement every two days.
I frequently have insomnia at night and excessive sleepiness in the morning.
I exercise very little.
Aside from that, there are no other abnormal conditions, but I am unsure why I have high blood pressure and a fast heartbeat.
Doctor, do I need to seek medical treatment and take medication for high blood pressure? Will it be like my mental illness, requiring medication for a lifetime? Thank you for your advice and diagnosis.

Gao Xue Ya De Nian Qing Ren, 20~29 year old female. Ask Date: 2009/07/11

Dr. Lai Hexian reply Family Medicine

Hello, I would recommend that you measure and record your blood pressure regularly for at least one week.
Then, bring the medications you are currently using and your blood pressure records to the cardiology outpatient clinic for further evaluation and treatment.

Reply Date: 2009/07/11

More Info

Understanding unexplained hypertension in young adults can be a complex issue, especially when considering the interplay of various factors such as lifestyle, mental health, and medication. In your case, it appears that you have been on antipsychotic medication for schizophrenia for about nine years, which can have implications for your cardiovascular health, including blood pressure and heart rate.

Firstly, let's address your blood pressure readings. The values you provided indicate that you have consistently elevated blood pressure, with systolic readings ranging from 133 mmHg to 149 mmHg and diastolic readings between 89 mmHg and 96 mmHg. According to the American Heart Association, hypertension is defined as having a blood pressure reading of 130/80 mmHg or higher. Therefore, your readings suggest that you are experiencing hypertension, which should be taken seriously, especially in a young adult.

Several factors could contribute to your hypertension. One significant factor is the long-term use of antipsychotic medications, which can lead to metabolic changes, including weight gain and insulin resistance, potentially increasing the risk of hypertension. Additionally, your lifestyle choices, such as infrequent exercise, poor dietary habits, and sleep disturbances, can also exacerbate high blood pressure. Chronic stress and mental health conditions, including schizophrenia, can further complicate the picture, as they may lead to increased sympathetic nervous system activity, which can elevate heart rate and blood pressure.

Regarding your question about whether you need to seek medical treatment for hypertension, it is advisable to consult with your healthcare provider. They can evaluate your overall health, consider the potential impact of your current medications, and determine the best course of action. It is essential to approach this condition holistically, considering both pharmacological and non-pharmacological interventions.
If your healthcare provider prescribes antihypertensive medication, it may not necessarily mean that you will have to take it for life. The management of hypertension often involves lifestyle modifications, such as adopting a heart-healthy diet (rich in fruits, vegetables, whole grains, and low in sodium), increasing physical activity, managing stress, and ensuring adequate sleep. These changes can significantly impact blood pressure and may reduce or eliminate the need for medication over time.

Additionally, your mention of constipation and sleep issues should not be overlooked. Chronic constipation can sometimes be linked to dietary habits and may require dietary adjustments or other interventions. Sleep disturbances, such as insomnia and excessive daytime sleepiness, can also contribute to cardiovascular issues and should be addressed. Improving sleep hygiene and possibly consulting a sleep specialist could be beneficial.

In summary, it is crucial to take your elevated blood pressure seriously and seek medical advice. A comprehensive approach that includes lifestyle changes, regular monitoring, and possibly medication can help manage your hypertension effectively. Remember that hypertension is a manageable condition, and with the right strategies, you can lead a healthy and fulfilling life.

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