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Q. I have chest heaviness with raised blood pressure. Do I need BP medication?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 27, 2020

Hello doctor,

I am a 39-year-old male. My height is 175 cm and weight 96 kg. I do not smoke or I do not consume tobacco or alcohol. I recently got my preventive health check-up done. My all blood tests are within normal range prescribed, including all cholesterol levels.

I do not have any particular persistent medical problem. Occasionally, randomly I feel pin pricking sensation over the left side of the chest and heaviness over the chest. I informed that to my doctor. So he got my 2D echo and ECG done. My 2D echo color Doppler’s conclusion is normal.

However, when I was seeing the doctor, my blood pressure measured as 180/90. I never had any BP related issues in the past. In the ECG report, doctor said there is minor variation. According to the doctor, mostly that variation is due to increased blood pressure.

The doctor prescribed me two medicines.

1. Corbis AM 5 mg +5 mg (Bisoprolol + Amlodipine) 1-0-0.

2. Ecospirin AV 75 mg +10 mg (Aspirin + Atorvastatin) 0-0-1.

Now, I have a tendency that whenever I see my doctor, I feel tensed thinking whether all will be right or not and my BP increases. But later, when I measure at home, BP remains within the limit. I informed that too to my doctor. But he insisted that there cannot be so much difference due to fear and insisted that I should start the medicine.

My questions Do I really need to start the BP medicine prescribed by the doctor keeping the context of my fear in mind? Is the variation in ECG due to BP? When all my cholesterol reports are normal, why the doctor prescribed Ecosprin AV and why not only Ecospirin? Do I really need to start that Ecosprin AV or normal Ecosprin will do? If I need to start those medicines, for what intervals should I take?

Dr. Muhammad Zohaib Siddiq

Cardiology General Practitioner
#

Hello,

Welcome to icliniq.com.

Only a concerning finding is on ECG. What to do in that case?

If first ECG (electrocardiography) done shows some abnormalities, but there is very low suspicion of disease on patient's history and examination, repeat ECGs should be done every half an hour for few hours. If changes resolve, it means ECG is normal and no need for medicines.

If subsequent ECGs are normal, no need for Aspirin and lipid-lowering medicine.

Blood pressure is high in doctor's office and normal at home is called white coat hypertension. This occurs in some peoples but good news is that trials show there is no increased risk of heart diseases in case of whitecoat hypertension. So, what to do? One option is to have daily BP checks and in few days, BP will come to normal. Better option is to check BP at home regularly. Home-based BP monitoring and BP readings are more closer to reflect real blood pressure in corresponding with cardiac issues. No need of any medicine in white coat hypertension.

What to do in your case because no serial ECGs were done? Have a repeat ECG done. Other better option is especially if you have chest pain is to have stress echocardiography done. It is a very simple, cheap, and non-invasive modality. If it is normal, stop Aspirin, Bisoprolol, and Atorvastatin. If home based BP is also normal without medicine, stop Amlodipine too.

Some lifestyle modifications are needed. Reduce weight, have a Mediterranean diet, do regular exercise at least 30 minutes daily for at least five days a week such as brisk walk, cycling, swimming, tennis, badminton, jogging, etc.


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