What are the best strategies for managing hypertension?

Question

Hi doctor,

I am a 29-year-old male. A year ago, I experienced severe headaches, a feeling of heaviness in my head, and tension. When I consulted a cardiologist, he conducted various tests and diagnosed me with high blood pressure (150/90 mmHg). He prescribed Telmisartan 40 mg and Amlodipine 2.5 mg for my high blood pressure. I took the medication for 15 days and then checked my blood pressure, finding it to be normal. Consequently, I stopped taking the tablets. While on the medication, I felt like I was losing my balance while walking.

Over the past few months, I have frequently experienced burning eyes, an intense heartbeat, and a sensation of increased pressure in my head and body. I also have a burning sensation in the soles of my feet. Due to this tension, I am unable to get sound sleep. I have consulted two doctors, and they said my blood pressure is normal but can sometimes be higher, reaching 130/90 mmHg. How should I proceed now?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have reviewed your query and understand your health issues. I assure you not to worry, as you have consulted the appropriate expert physician who will address all of your medical concerns.

Your blood pressure (BP) was initially high, which is why you were started on medication for hypertension. I want to emphasize that this is still not ideal for your age, and it may rise in the coming years.

Could you please provide any history of diabetes, high blood pressure, stroke, paralysis, or heart disease in your family? If so, this increases your risk of encountering these issues sooner or later unless you receive proper treatment now. Do you smoke or drink alcohol? If yes, please mention the frequency and quantity. Additionally, please check your pulse rate and blood pressure today and include the readings in your follow-up.

Could you also provide your height, weight, waist circumference, and activity level? If I were to scale your activity level from one to 10, what number would you give it? These answers are crucial for determining the initial line of treatment. My advice for someone your age is primarily focused on lifestyle changes and habit modifications based on the clinical scenario you present.

I will develop a diet and exercise plan for you, along with a mild antihypertensive medication if needed. Our goal will be to transition slowly from medication to lifestyle changes, ensuring that your health remains under control regarding this issue. You may need medication, but if I simply prescribe it at such a young age, you may have to take it for life. What I expect from patients like you is a complete medical history.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I want to assure you not to worry, as everything will be fine soon. Your body mass index (BMI), which measures the appropriate body weight for your height and age, is higher than normal, placing you in the overweight category and making you prone to obesity. If you start following my advice, you will improve with a little determination and lifestyle changes. Your ideal weight ranges from 121 pounds to 160 pounds. You have central obesity, and your waist circumference for your age and height should not exceed 34 inches.

For every 10 pounds you lose, you can expect a beneficial drop of about 5 mmHg in blood pressure until it normalizes. I recommend using a pedometer; most smartphones have this feature built-in, or you can use a separate device. Your goal is to achieve 10,000 steps daily at a brisk jogging pace for at least five to six days a week consistently. Please create a daily chart with dates and share it with me during your follow-up appointment.

You do not need weightlifting exercises; instead, focus on cardio exercises to support your heart and blood pressure. Previously, Telmisartan and Amlodipine may have caused hypotension as a side effect, which could explain your experience of losing balance while walking. It is good that you discontinued those medications. The rest of the symptoms you mentioned in your previous question are likely due to anxiety and high blood pressure. For that, you will need medication to control your blood pressure, and I recommend a follow-up appointment in a week to monitor your progress. The follow-up will help us assess how you are responding to the treatment.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

I am very pleased to see your follow-up query and am happy to assist you. I am amazed by the remarkable improvement in your health status. You are doing exceptionally well, and I appreciate the efforts you have made for your well-being.

Blood pressure can fluctuate daily due to various physiological processes, but your readings are all normal and excellent with your current medication. Congratulations on achieving such fantastic results in such a short time through your efforts and activities! I hope you continue to make this a routine and maintain your health for the long term.

It is important to take your medication regularly at the same time each day. Consider setting an alarm to remind you to take your medicine daily. If you forget one day, take it as soon as you remember, but resume your regular dosing schedule the next day.

Additionally, please pay attention to your diet. Aim for a low-salt, low-sugar, and low-fat diet. Avoid soft drinks, alcohol, energy drinks, and cigarettes. Limit your intake of tea, coffee, and chocolate.

I hope this helps you.

Thank you.