Dr. Nishith Chandra
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am 31 years old with a weight of 191 pounds and height of 5 feet 7 inches. I have a problem of high BP. There is little chest pain. ECG report (leftward axis). Echo report (mild concentric LVH and diastolic dysfunction and normal systolic function). LVEF 60 %. Total cholesterol 213. TSH normal. No sugar. Creatinine normal. Renal Doppler report (no evidence of renal artery stenosis). History of alcohol and smoking for the past five years, now quit. Currently on medicine Nebistar SA (Nebivolol 5 mg and Amlodipine 2.5) and in evening Eslo 2.5. BP was 160/120 now 130/90-95. Please advice whether the medicines are alright or not. Any changes in medicine you would like to suggest? Will be very thankful if you kindly respond to my request. Thanks a lot.
Hello,
Welcome to icliniq.com.
I have seen your reports (attachment removed to protect the patient's identity). Your echo is almost normal. Your current medicines appear to control your BP adequately. So, there is no need to change them. But your weight of 191 pounds for your height of 5 feet 7 inches is very high. That is the reason for your high BP. If you want your BP to be controlled without taking any medicines, you have to reduce your weight to 165 pounds. Warm regards.
Patient's Query
Hello doctor,
Thanks a lot for your quick response. Three questions, please. Had I lived in your city and came to you with mild concentric LCH, LVEF 60 % and a high BP of 160/120 mmHg, what medicines would you have prescribed me? One of my family doctors said beta blockers (Nebivolol) along with calcium blockers are more effective in young patients with mild LVH compared to ACE inhibitors or ARB's, etc. Do you agree? Does mild concentric LVH regress with medicine, exercise, and proper diet? If so, how many years does it take approximately?
Hello,
Welcome to icliniq.com.
Mild concentric LVH (left ventricular hypertrophy) does regress with tight BP control, exercise, and diet. I fully agree with the medicines prescribed to you.
Patient's Query
Hello doctor,
Hope you are fine. Please check my latest echo. I have mild concentric LVH. I am very worried at the moment. Could you please tell me if I can go to the gym and exercise to reduce weight? Can I do cardio at the gym and lift mild weights like dumb bells and do push-ups? As I am obese, will weight loss, diet and BP control regress the left atrium diameter (40mm) and mild LVH? Will it regress within a year from 11 mm to (6 to 11 mm range) as my medical for job is one year away? Thanks a lot.
Hello,
Welcome to icliniq.com.
You must consult a cardiologist in person. He or she would decide after examining you thoroughly.
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Cardiology
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