Continuing Blood Pressure Problems

[theolocke]

I am a 31 year old male, 6'4, 195lbs. I visited a cardiologist in April 2010 because of palpitations during exercise. I had an echo done: trace mitral and tricuspid inefficiency, EF 53%, left ventricular motion is borderline reduced, but structurally normal. Duke treadmill score of 12.5, no significant ischemic ECG changes, resting ECG nonspecific ST wave abnormalities, maxed HR 203. Two months later I was still having issues; my cardiologist put me on an event monitor. During the 30 days I had a few PVC's. I told him that my diastolic reads high after exercise; my systolic was high in the office.  I am hypertensive, I take 10mg Ramipril and he put me on 12.5mg of HCTZ. Recently, I started experiencing dizziness during exercise (slow jogging), not spinning but a loopy feeling. So I was told to come in for another stress test. I took it today. A different cardiologist was attending. He stopped the test when he saw ST depressions when I stood up to get on the treadmill, I was nervous and they went away. My heart rate is often at 58bpm at home and goes up to 85 when I stand up, not 140 like today. After he looked through my file, we resumed.  I was fine, but my blood pressure fluctuated abnormally.  Resting: 142/78; stage one: 152/88; then 160/100; then 160/60; final stage, after 11 minutes: 132/62; HR 185 bpm. The cardiologist told me only to exercise moderately until my follow up; my regular cardiologist will probably change my BP treatment.  I have read that changes in diastolic blood pressure are indicative of CAD.  But I recently had an angioscreen, and everything came back normal.  My total cholesterol is 137.  I think I might be a hypochondriac and I have anxiety issues, but I am worried that something really is wrong.  Everything except the fluctuating blood pressure seems fine.  Do I have some hidden problem?  My last chemistry check showed a low osmolality, 276.  Is that a problem?  Could it be the blood pressure medicine affecting my diastolic pressure?

[CCF HeartMD3]

theolocke,

It sounds as if your doctor has you on a good medical regimen for your high blood pressure. Sometimes finding a dose which is just right can be challenging as you can now attest to.

As for your blood pressure during exercise, it is common for your blood pressure to increase with exercise (it is actually abnormal for it to go down). Your blood pressure should only be checked after you have been sitting, quiet and rest for 5 minutes.

Hope that this helps.

[theolocke]

The medication treatment I am under works great for my resting BP; it is usually 115/70.  My question has more to do with the fluctuation in my exercising BP.

[theolocke]

I should note that it was an angio-sceening, not the angiogram with x-ray.