BP medication

[Deb Willardson]

When should a hypertensive patient begin to see the benefits/effects from anti-hypertensive medication.  The person was taking vasotec and is now taking lotrel.  Yesterday his BP was 130/110 after 5 days on lotrel.
Thanks.

[CCF CARDIO MD - DLB]

It usually takes one to two weeks for the full effects of the medications to become apparent.

[Ben]

When should you go on medicine for high blood pressure?  Mine is usually about 140-145/80-85.  My doctor says he's a little concerned about that level for a person my age (I'm only 23), but then didn't make any recommendations.  There have been a few times when I suddenly start feeling nauseous and my left arm feels heavy and painful, and when I check my blood pressure in these times it's like 150-155/90-100.  Any idea what could cause random spikes in blood pressure?

Thanks much...

[Ben]

When should a person go on medication for high blood pressure?  Mine is routinely about 140-145/80-85.  My doctor says he's a little concerned about these numbers for someone my age (I'm only 23), but then didn't give me any recommendations.  Every now and then I'll have a period where I suddenly start feeling sick and my left shoulder and arm get painful and heavy feeling.  If I check my bp in one of these periods, it's like 150-155/90-100.  Any idea what could cause a random spike in blood pressure like that?

Thanks much...

[CCF CARDIO MD - DLB]

Blood pressure routinely varies from minute to minute. I do not know what is causing your symptoms of nausea and arm pain - high blood pressure can definitely do that, but usually it has to be higher than the numbers that you mention. Alternatively, the pain and nausea might be the cause of the blood pressure getting higher, not the result of high blood pressure. At any rate, if your blood pressure is getting that high at times, it probably needs to be treated with medications. You ought to discuss this with your doctor, especially the symptoms.

[GG]

medical texts state that an aggresive search for secondary causes of elevated BP in young people should be made before commencing treatment.  What should these tests involve before one would accept a lifetime of hypertensive meds from early to mid twenties onwards??

also, what can cause elevated VMA, catecholamines and met and n/met values other than a pheo??  what if these tests all show raised values but a CT scan is unrevealing??  what should be the next step??  are there any medications which can actually stop over-production of catecholamines (and not just block their action)??

Thanks