Dr. Muhammad Zohaib Siddiq
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 started to experience hypertension for the past few days, which started after my father's death. Then I visited a local cardiologist and then decided to start on Nebilet 5 and Diovan 80. Even while taking the medication for unknown reasons, my blood pressure started uncontrolled again, so the doctor decided to change Divoan to Exforge 5/160. It works well until I tested positive for COVID -19. On day 12, I felt chest pain, hard to breathe due to increased blood pressure. And doctor decided to do Cath and shows normal instead of 60% and said it is not important and I can share the results. I experienced uncontrolled hypertension even with the same medication and did many lab tests. My doctor changed Exforge to Vocado 40/10/25. I could not tolerate it, and my heartbeat becomes fast and uncomfortable all the time. Then I returned by myself to Exforge 5/160 and Nebilet and started measuring my BP daily for one week after working hours and having my main meal and rest for 30 minutes. I have attached my one week's blood report. 145/95 mmHg, 125/75 mmHg, 130/90 mmHg, 140/90 mmHg, 140/90 mmHg, and 150/90 mmHg. But I still feel uncomfortable as sometimes I feel too hard to breathe only, so I need advice and a second opinion
Hello,
Welcome to icliniq.com.
I have read your query and all your lab reports (attachment removed to protect patient identity) and found all are normal. I can understand your concerns and worries and pain you are going through. Your doctor wanted to dig the secondary cause of uncontrolled blood pressure, so he asked you for this vast number of tests, and fortunately, the tests are normal. Some points should be put in mind for blood pressure. Blood pressure is a dynamic entity and keeps on changing from time to time and from activity to activity. For example, blood pressure will be higher when one does vigorous exercise or under stress and will be lower when one is relaxed or sleeping. Blood pressure readings will be incorrect if measuring blood pressure is not optimal or if the patient is not fully relaxed. Adherence to a medication regimen is a must, along with lifestyle modifications, dietary modifications, and stress management, including proper uninterrupted sleep. Your blood pressure readings are slightly above the target. Reduce weight. Do daily exercise. Adopt an active lifestyle and refrain from sedentary behavior. Take a Mediterranean diet and take proper sleep uninterrupted. Escalate the dose from 5/160 to 10/160 and continue Nebivolol. Assess blood pressure over a few weeks of all these measures. Your blood pressure will reach targets soon.
Patient's Query
Thank you doctor,
I will follow your advice and hope things will get better.
Hello,
Welcome back to icliniq.com.
Measure BP while you relax. Sit for five minutes in a quiet room without talking to anyone. Empty your bowel and bladder before checking BP. Avoid tea or coffee 30 minutes before checking BP. Sit on a chair with feet on the ground, back supported, hand supported on a table, cuff at the position of the heart. Check BP, and repeat after five minutes again. Then check the BP in the other arm and repeat after five minutes. During the entire period, remain to relax and quiet. You may take at least two or more readings, and an average of readings is your actual BP.
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Cardiology
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