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How to deal with BP and anxiety, causing palpitations?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am a 26-year-old male. I am having hypertension, palpitation, depression, and anxiety. ECG, 2D echo, renal Doppler, VMA culture, cortisol, and lipid profile are normal.

I need advice.

Answered by Dr. Rohit Jain

Hi,

Welcome to icliniq.com.

The tests you have mentioned are used to find a cause for significant hypertension. You have not mentioned anything about your BP (blood pressure) levels and whether they are really significantly high. We have no details of your weight, your lifestyle, or your family history.

There can be a possibility of hyperthyroidism, which would cause all these features in a normal-looking adult.

Also, you should get a psychological evaluation done. Alternating depression and anxiety shows that you are under severe stress and tension due to some cause.

The BP being high might just be a sign of that stress. Please get a thyroid function test done and look for a more common cause. Medications will help a lot. Consult a cardiologist for further help.

I hope this helps you.

Thank you.

Patient's Query

Hi doctor,

My current BP level is normal, usually between 120/80 and 130/80. My main problem is palpitation. I can feel heart rate even when I am resting. If I do exercise, it becomes annoyingly noticeable. Whenever there is some stress, my BP shoots up to 150/90 on a regular basis. I am not on any type of medication. Yes, my thyroid tests were normal, along with other tests that my doctor performed to diagnose young age hypertension.

I always complain to my doctor that I have an abnormally fast pulse, but he always blames my anxiety, which is partly true. But even in the utmost comfortable position, my pulse is above 100, which certainly was in the direction of some cardiac arrhythmia. I did a standard stress test today. The report says TMT is negative, but the resting ECG shows sinus tachycardia. I am attaching reports here. Please advise further tests.

I have had my psychological evaluation done. Based on the history and test findings, the impression is currently suggestive of mixed anxiety and depressive disorder with predominant Cluster C personality traits on Axis II.

Please let me know if you need more details.

Answered by Dr. Rohit Jain

Hi,

Welcome back to icliniq.com.

Do not worry. No major abnormality is seen in your reports. Do not get so many tests done. In any case, TMT would have come out negative. You are too young to have a blockage. My suggestions are to start on tablet Metoprolol (Metoprolol) 25 mg once a day. This will reduce your heart rate to normal levels, decrease anxiety, improve any arrhythmias, and you will feel relaxed. Also start on any anxiety reducing drugs; tablet Alprax (Alprazolam) is the safest to start 0.25 mg at bedtime.

Please do not worry about things so much; you are just fine.

I hope this helps you.

Thank you.

Answered byDr. Rohit Jain

Medically reviewed byiCliniq medical review team

Published At July 23, 2018
Reviewed AtMarch 10, 2026

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