Controlling Blood Pressure.

[knicks30]

Im a 19 year old hispanic male. I've been suffering from Hypertension since January probably before then im not sure. In Jan. read 150/90 and doctor quickly put me on Diovan 80 mg. Still at times was 140 to 155/ 80 to 105. Every visit i told my doctor the medicine is not working, i stopped taking it in July. From july to september my blood pressure ran 160/100 until my cardiologist put me on Diovan 160 mg and Cardizem 240 mg. Then Cardio put me through tests for secondary causes, had blood work, 24 urine test, MRA w/contrast, and a kidney ultrasound and everything was normal. Since everything was normal he said i need to lose more weight and get some excersise. With both pills i run a bp of about 120-150/70-80.

Back in jan. of 2003 i used to weigh 300 lbs and lost 55 pounds. Currently 6 foot even 245 lbs. I'll tell you the truth i lost that wieght because of diet i stopped eating at night like a pig and stopped eating so many greasy foods. I constricted my calorie intake and fat and carbohydrate intake. I lost so much weight through diet that i could be in my healthy range of weight had i excersised more often.
Ive started excersising but starting slow by walking a hour straight w/o stopping. I've increased my FIBER intake, take a fish oil, increased my folic acid intake, drinking a gallon of water daily.

So my questions are:

1) When you doctors say Losing weight will help lower your blood pressure...do you mean losing weight by excersising or diet?

2) I had a echo back in Feb. of 2003 and my cardio said it was normal but then 7 months later he talked about my echo again and said my left ventricle was a little enlarged. Why didn't he say this back in Feb of 2003? Is it to scare me to lose more weight or did he lie to me?

3) Since he told me that i started to panic but doctor said that with good blood pressure control it will regress..is that true? I use your search engine on this site alot and alot of doctors that used to help here said that is true not true, what gives?

4) What if i bring my weight down more but this time with excersise included in my diet and it' doesnt lower my blood pressure, what's next?

5) I used to swim alot when i was younger but stopped, got lazy...will swimming help lower my blood pressure?

6) I've read that magnesium will help medications in lowering blood pressure, is that true?

7) Am i at risk for sudden death with the LVH finding?

Again im 19 years old Male.

Thank you for your service.

[Cleveland Clinic]

thanks for the post

1) When you doctors say Losing weight will help lower your blood pressure...do you mean losing weight by excersising or diet?

Both.  Successful weight loss needs to incorporate both. Fad diets without exercise have minimal success in the long run. Also, improved cardiovascular fitness will have synergistic beneficial effects in addition to the weight loss.

2) I had a echo back in Feb. of 2003 and my cardio said it was normal but then 7 months later he talked about my echo again and said my left ventricle was a little enlarged. Why didn't he say this back in Feb of 2003? Is it to scare me to lose more weight or did he lie to me?

Im sure he didnt deliberately mislead you.  I cant comment about his statement. Either way, you should be focused on blood pressure control and weight loss even if the numbers are normal.

3) Since he told me that i started to panic but doctor said that with good blood pressure control it will regress..is that true? I use your search engine on this site alot and alot of doctors that used to help here said that is true not true, what gives?

Yes. There is evidence that tight blood pressure control can have beneficial effects on LV hypertrophy.

4) What if i bring my weight down more but this time with excersise included in my diet and it' doesnt lower my blood pressure, what's next?

More drugs. As of now, you are not on a diuretic. This would be an important drug. I usuall favor this drug as first line in treating hypertensive patients. Again, it would be important for you at such a young age to have a thorough evaluation of other causes of hypertension.

5) I used to swim alot when i was younger but stopped, got lazy...will swimming help lower my blood pressure?

Yes. Any form of exercise will be beneficial.

6) I've read that magnesium will help medications in lowering blood pressure, is that true?

No. There is no evidence this is true.
  
7) Am i at risk for sudden death with the LVH finding?

No. LVH itself is not a risk factor for sudden death.  For now, I would work on weight loss exercise and blood pressure control with medications.  


good luck

[knicks30]

Well i thought i had a thorough evaluation for "secondary" causes. Like i said i had blood work, 24 hour urine test, MRA w/contrast(DYE) of the kidneys and Ultrasound of the kidneys.

What other secondary causes do i have to look for? endocrine disorders?

And what is a good diuretic available?

What about anxiety or stress? Can i take some medication for anxiety since i do get angry really easily and i worry alot, will that help my blood pressure?

Again thanks alot Doc really appreciatte it.

[Paule]

You've had all the workups for endocrine disorders...the 24 hour definitely ruled out a rare condition that causes runaway hypertension (these tumors are very very rare) your kidneys were looked at and your bloods were evaluated...there is not much more you can get.  Your doctor ruled out every cause.  Whats left is genetics, stress and lifestyle etc.

My neighbor was very overwieght, he recently retired and lost a lot of weight through dieting and excercise (walking 6 miles a day).  He was on five medications and is now on zero.  He looks great and feels great.  He is only 48 y/o!

My brother, very thin has hypertension, lost battle to beat it through stepped up lifestyle changes, just went on Lotensin and is doing fine and is probably averting lots of damage.  Unfortunately, he may have waited too many years hoping he could beat it with diet.  Your lucky in that your aggressively fighting it and at a young age both pharmacologically and with aggressive lifestyle changes.

Diuretic?  Depends, HCTZ (hydrocholorthiazide) is cheap and works great.

If your potassium is low, eat an orange every day or your doctor will have you take a potassium sparing diuretic.

Some drugs have diuretics already in them, but one drawback is the dosing flexibility. Depending on when you dose, it may lead to frequent bathroom breaks esp at night.

[knicks30]

Thanks alot Paul...that really inspired especially the story of your neighbor. Sorry to hear of your brother i hope he will do much better with the medication.