Isolated Systolic Hypertension - Young Male

Hi Dr,

I am a 27 year old male with a history of both athleticism and sedentary lifestyle (professional endurance athlete up to 21, and afterward, mostly sedentary after).  I am 6'3", 220lb, with a BMI of 27.5 (overweight as per CDC website).

Two years ago (age 25) I used a caffeine and ephedrine 'thermogenic' weight-loss drug for 6 weeks. As i recall, the dosage was apx 20mg ephedrine, 200mg caffeine.  I did not intensify the dosage and have not used it since.

18 months ago I had my blood pressure taken, which was at 155/80.

Last week i took my BP again at the doctors office - 180/80 (i was very stressed and anxious that day).

Today i surveyed my blood pressure while resting in bed, and on a very light diet of fruits and vegetables. It was taken with a personal blood pressure machine at on both arms - no noticeable difference. These are the results:

Systolic: 148; Diastolic: 69; Heart Rate: 64

*these are averages from a sample of 16
*outlier not included in sample: 181/72 after argument.

Summary:
18 months ago: 155/80 (Physician)
1 week ago: 180/80 (Physician)
Present: 148/69 (Personal test)

Both my grandfather on my mothers side, and my grandmother on my fathers side have had heart-bypass surgeries. My Uncle on my mothers side had a heart attack at age 60.

Thoughts and or Recommendations?

Thank you very much for your time and this service.

[Cleveland Clinic]

Based on your results I would say that you have hypertension and need to be treated. I prefer hydrochlorothiazide as a first line agent, as it has the least amount of side effects, but this may not be enough in your case. I would also take a baby aspirin daily given your family history. Given your lack of symptoms I don't think you need a stress test, but your cardiologist may disagree.

[zvxswc]

While at the Doctors office a week ago, he listened to my heart and concluded that it sounded 'fine'.  He also listened, i think, to my chest - no problems.

He arranged for blood tests and a cardiologist.

[zvxswc]

Sorry for bombarding you with edits:

I am a non-smoker and non-drinker.  I eat very healthy - low/no-salt diet.

My life, however, is very stressful.