Question Title: 28 year old with high blood pressure

Hi! I am a 28 year old female who has been a runner for 15 years (5-8 miles six days a week), 5'8", 140 pounds, non-smoker, occasional weekend alcohol drinking, have a 2 year old daughter, wonderful husband, and little stress in my life. Last October I was in for a routine check-up with my GP and my blood pressure reading was 185/112 and my resting pusle was 120 bpm. I had never had high blood pressure before - not even in pregnancy. They immediately hooked me up to an EKG and it was completely normal. My GP sent me to an internist for further evaluation. He in turn has sent me to a cardiologist. I have been through an echocardiogram, have had probably 10 EKG's, holter monitor, blood pressure monitor, arrythmia monitor, stress test (where you run on the treadmill), renal artery checked twice, kidney function tested, brain scan, 24 hour urine test, adrenal glands tested, you name it - I've had it done. They can't find anything wrong with me yet my pressure remains high. Oh and they took me off all drugs I was taking at the time and it was still high. So they put me on Lopressor 50 mg in the a.m. and 50 mg at nite. Which I have been on about 5 months. It is still high so my doc just put me on Norvasc 2.5 mg once a day in combination with the Lopressor (I understand the beta blocker lowers my pulse). We are now waiting to see if this lowers my BP reasonably. I have also recently developed PVC's which I HATE! but the beta blocker seems to control them okay. This whole year has just been a disaster - I have extreme upper back pain which physical therapy is not helping. I had JRA when I was 7 that went away when I was 10 (in my knees only). We are now doing a test to see if it is in my back. I am still running but am tired all the time from the meds. I am looking for anyone who has an idea of what is wrong with me so I could possibly fix this with surgery or whatever! I'll do anything. I'm also worried all the time that my heart isn't working right because all of a sudden it will just speed up real fast for 5 minutes then slow down again. This is not normal for a person who runs as much as me and is not overweight. This whole medical thing has caused me more stress in the past year than I have EVER had in my whole life! I'd rather not take medication that makes me dizzy and tired for the rest of my life...I stay home with my child and that combo just doesn't work. ANY IDEAS?????????????????????? I'm desperate.
I really appreciate you taking the time to read my whole story. Thanks
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Dear Kimberly,

Topic Area: Hypertension

Your case is not typical but it certainly can occur. It sounds as if you are receiving good medical care and have been appropriately evaluated for your hypertension. I have given you some information about HTN below. Hope this helps.

High blood pressure, or hypertension (HTN) , is defined in an adult as a blood pressure
greater than or equal to 140 mm Hg systolic pressure or greater than or equal to
90 mm Hg diastolic pressure. Blood pressure is measured in millimeters of
mercury (mm Hg). High blood pressure directly increases the risk of
coronary heart disease (which leads to heart attack) and stroke (or brain
attack), especially along with other risk factors.

High blood pressure can occur in children or adults, but is particularly prevalent in
blacks, middle-aged and elderly people, obese people, heavy drinkers and women who are taking oral
contraceptives. Individuals with diabetes mellitus gout or kidney disease have a higher frequency of
hypertension.

High blood pressure may be primary (essential) or secondary. If the hypertension is secondary there may be a treatable cause. Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma). If no secondary cause is found then the high blood pressure is said to be primary. The vast majority of cases of HTN are primary. The main cause of primary HTN is genetic.

Q: How do salt and sodium affect high blood pressure?

A: Most Americans consume far more salt (sodium) than their bodies need. Heavy sodium consumption increases blood pressure in some people, leading to high blood pressure. People who are diagnosed with high blood pressure are often placed on restricted-sodium diets.

Reducing sodium (or salt) consumption may help lower blood pressure in some people. Your doctor may
recommend a sodium (salt) restricted diet. This will mean you'll have to avoid salty foods and cut down on the amount of salt you use in cooking and at the table.

Q: How does being overweight affect high blood pressure?

A: Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels. These factors have been linked to the subsequent rise and development of high blood pressure. People who are overweight are more likely to have high-normal to mild high blood
pressure.

Physical inactivity is a risk factor for heart disease. In addition, a sedentary or inactive lifestyle tends to
contribute to obesity, a risk factor for both high blood pressure and heart disease. Regular exercise helps
control weight and lower blood pressure. Don't be afraid to be active - exercise should definitely be part of your daily program. Besides helping to reduce your risk of heart attack, it can also help you lose weight or maintain a healthy weight.

Statistics show that many people who have high blood pressure are also overweight. If you are overweight or have gained weight over time, you'll be advised to cut down on calories and lose weight. Your doctor can prescribe a diet that's right for you.

If you're given a diet, follow it closely, including any recommendations about reducing your consumption of alcohol. Alcoholic drinks are high in non-nutritious calories, so if you're trying to lose weight, avoid alcoholic beverages. Often when people lose weight, their blood pressure drops as well.

Q: How does medicine help control high blood pressure?
A: For some people, weight loss, sodium reduction and other lifestyle changes won't lower high blood pressure as much as it needs to be lowered. If that's your situation, you will probably need to take medication. Many medications are available to reduce high blood pressure. Some get rid of excess fluid and sodium (salt). Others relax constricted blood vessels. Others prevent blood vessels from constricting and narrowing. Because there is usually no cure for high blood pressure, treatment generally must be carried out for life. If treatment is stopped, the pressure may rise again.

Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.

Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.

Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs. There are many different medications and new ones are coming out each year.

Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families. Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).

http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

• HTN

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