Will my diabetes and hypertension affect my heart health?

Question

Hello doctor,

I am requesting a cardiovascular evaluation as part of my deployment physical and would like a second opinion.

I have two concerns that were raised during my evaluation:

High blood pressure is well controlled with Lisinopril 40 mg once daily. I run at least three miles per day and have no history or symptoms.
I was previously diabetic, but through regular exercise and lifestyle changes, my blood sugar levels have been well-controlled. I am currently taking Synjardy XR 12.5/1000 mg twice daily, and my sugar levels are stable. I also take Omeprazole 40 mg once daily.

Please review and advise regarding my cardiovascular fitness for deployment clearance.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern regarding deployment.

Since you have both diabetes and hypertension, although currently well controlled with medication, your overall risk of developing coronary artery disease remains slightly higher than that of the general population.

Given your recent elevation in HbA1c (glycated hemoglobin), it is important to rule out any underlying cardiac condition and check for signs of end-organ involvement before deployment.

Your excellent fitness level, running three miles daily without any symptoms, makes significant cardiac disease less likely.

However, to confidently exclude all possibilities, a definitive cardiac imaging study such as a stress echocardiogram or stress myocardial perfusion scan is recommended.

Regarding your laboratory results, your urine report showed 3+ glucose (indicating uncontrolled blood sugar at that time) and 1+ protein. The protein loss suggests mild diabetic kidney involvement.

With good control of blood pressure and blood glucose, this mild proteinuria is unlikely to progress further.

Based on your medical history, current control status, and physical performance, there are no immediate cardiovascular contraindications to deployment. However, completing a stress echocardiogram or myocardial perfusion scan will provide a comprehensive assessment.

Your chronic conditions appear stable with no functional limitations, though continued medical supervision is strongly advised.

I hope this information helps.

Please do not hesitate to contact me if you have further questions. I would be glad to assist.

Thank you.