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25yr male with hypertension. Need a second opinion.

 

Customer Question

I'm a 25 year male, recently diagnosed with hypertension. My recent blood pressure reading was 160/100. I was prescribed medication to control it, but I fear that it may lead to dependence on it. I'm here for a second opinion. Also, are the tests prescribed in the prescription really necessary? If so, why? Thanks.Prescription Page 1 of 2Prescription Page 2 of 2

 

Optional Information:
Person's Gender: Male
Person's Age: 25

Already Tried:
I've not started any medication. I'm an IT professional with a very sluggish lifestyle. I weigh 85kg. I've been prescribed Telmax (40+50) 1 tab. a day post breakfast for the next 10 days. Will try and attach my prescription.

Submitted: 290 days and 20 hours ago.
Category: Medical
Value: $25
Status: CLOSED
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Expert:  Dr. Abby replied 290 days and 19 hours ago.

I am sorry for the delay in responding...I was not online.

I am looking over your question now. I will get right back to you...

Dr Abby

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Expert:  Dr. Abby replied 290 days and 19 hours ago.

I have looked over the prescription...

It appears that he has ordered an ECG, renal doppler and an eye exam.

A few questions for you first before I discuss everything..

How long have you been having these high blood pressure readings?
Do you have a family history of high blood pressure?

Customer replied 290 days and 19 hours ago.

I've only started taking reading a few weeks ago using an electronic BP monitor and I was consistently getting high readings before I decided to see a physician.


My dad has been taking medicines for hypertension for years now, while my mother too has mild hypertension.

Accepted Answer

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Expert:  Dr. Abby replied 290 days and 19 hours ago.

Thank you for the information.

First I want to address the testing your doctor has ordered...

Because you are only 25 years old, most physicians (myself included) will order a workup to rule out any secondary causes of high blood pressure.

The majority of adults have what we call "essential hypertension". What this term means, basically, is that there is no underlying reason for the high blood pressure (no narrowing of an artery leading to the kidney, no heart abnormality, hormonal abnormalities, etc). The fact that you have a family history of high blood pressure is probably why you have it as well (which puts you in this category)

When younger adults have high blood pressure, however, there is a higher (although still rare) likelihood that a secondary cause exists for the high readings. Some of these causes include narrowing of the renal arteries (thus your doctor has ordered the renal dopplers), hormonal abnormalities (such as tumors that secrete epinephrine and norepinephrine), abnormalities of the aorta...

The ECG and the fundus exam are both looking for any damage that may have been caused by your high blood pressure...the fundus is the back of your eye. If you have high blood pressure for a long period of time, we may see changes in the blood vessels in the back of your eye. The fundus exam will also tell us if you have elevated pressures within the brain, which can also be a serious association with high blood pressure (usually higher readings than yours).

The ECG may show signs that your heart muscle has thickened if you have had high blood pressure for a long period of time. An ultrasound of the heart is another test that I would normally order--this looks at the structure of your heart.

Lastly, as for medication--this depends. Since you have only had a few readings that have been high I may give you time to lose weight, exercise and eat healthy (two months or so). But, your doctor may have seen something on your exam or have had other reasons for starting you on the medication.

If you had high readings for a longer period of time (which you may since you have not checked your pressures until recently), it may be time to start you on something. Seeing that you have had chest pressure (written on the prescription) this may be why your doctor started the medication. If you are overweight and do not exercise (as you have mentioned), making changes may allow you to get off the medication in the future.

I hope that this answers your question for you...

Please ask any follow up questions that you may have,

Dr Abby

If you are not satisfied with my help and do not wish to rate me positively, please ask further questions so that I may help you until you are happy with my answers. Thank you!!

Expert TypeUS Board Certified MD
Category: Medical
Pos. Feedback: 99.9 %
Accepts: 7169
Answered: 6/26/2012

Experience: Family Physician practicing medicine for over 10 years, United States

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Customer replied 288 days and 6 hours ago.

Dear Dr Abby,


My apologies for replying so late. I was undertaking all the tests my doctor had prescribed. Renal Doppler, fundus exam, ECG, all appear normal. Even my home electronic BP monitor is reporting relatively lower readings 135/87. Do you still I should start with the medication. Should I get an ultrasound of heart too?


Renal Doppler Report


ECG


Fundus Exam Report

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Expert:  Dr. Abby replied 287 days and 21 hours ago.

Sohail,

I am so happy that your tests have come back normal. That is great news.
As I am sure you understand, I cannot replace the advice of your own doctor who has examined you in person.
However, the fact that your blood pressures have been lower than 140/90 does suggest that you may have some time to work on your lifestyle before starting medication.
I encourage you to discuss this with your doctor...if you are truly running these numbers for the majority of the time, I suspect he would be amenable to a trial of lifestyle modification and close monitoring of your blood pressures first before medication...

I believe the ultrasound could wait given the normal testing too.

Dr Abby

 
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