Hypertension?

[bellick]

I had my Blood pressure taken on 3 occasions at 2 different clinics. It was 140/92 during the first measurement on my first visit. During that same visit, my blood pressure was taken again, abt 10 mins apart from the first reading. It was 150/80 this time round. On my next visit, which was exactly 1 week later, it was found that my BP was 150/79.

Hence, I was referred to a hospital. Yet again, my BP was 140/90 when measured by a senior cardiologist. Both times at the 2 different clinics, the ECG indicated a sinus rythmn and right axis deviation which meant pulmonary disease pattern with RVH. It also indicated 1st degree AV blockage.

As such, the cardiologist ran an Echocardiogram, blood tests, 24 hrs urine test and 24 hrs blood pressure monitoring. It turned out that the Echo was normal; no evidence of atrial septal defect, no aortic coarctation. The Thyroid screen turned out to be normal along with the renal test. In addition, the 24 hrs BP report indicated normal mean BP. However, my max systolic BP was 152 during the day and 133 during the night. My max Diasystolic was 97 and 64 during the day and night respectively.

My family has a history of hypertension.

I was just wondering if I truly have hypertension? Or could it be White Coat Hypertension? Or could it be prehypertension as I have a family history?  

[Barbarella]

I'd get a second opinion.

[bellick]

Apparently, the doctor diagnosed me with 'White Coat Hypertension' which I think is ridiculous. That does not explain the abnormal ECG and high BP recorded.

Furthermore, I have a very strong genetic predisposal. So I really cannot understand. The doctor did not subject me to further tests as he believes that it is 'White Coat'.

In summary, here r the test results:

24hrs BP monitoring: Normal

Echocardiogram (heart): Normal systolic function and chamber sizes

Blood tests (Thyroid): Normal

Urine (Pheochromocytoma): Normal

ECG: Abnormal (Sinus rythmn and right axis deviation, pulmonary disease pattern with RVH. 1st degree AV blockage.)

No treatment was administered. What the hell!

What is ur opinion? Thanks and regards.

[Barbarella]

An echo cannot determine blockages neither can an EKG only an angiogram.  

As for further tests:  A stress test I would think.

[bellick]

Actually, I took an ECG on two separate occasions, one and a half months apart, in two different clinics. Both times it indicated a sinus rythmn and right axis deviation which meant pulmonary disease pattern with RVH. It also indicated 1st degree AV blockage.

I think my doc may run further tests.... But what other more detailed tests can be performed? In the first place, is echocardiogram accurate enough?

Coz my Dad, who is hypertensive, did an ECG and Echo, both were perfectly normal. The doc then put him through a treadmill test and noticed a very slight dip upon recovering from the run. Thus a Coronary Angiogram was ordered and it was found that two artries were almost completely blocked. A medicated stent was then inserted to clear the blockage.

[Barbarella]

Since your EKG was not normal what did the doc say i.e. a follow up test to see what is going on?  Another EKG?

I had an abnormal EKG at one time, it said that I had a previous heart attack, it said that I had S3 Gallop.  Scared the hell out of me.  I had to undergo several tests which ruled out a previous heart attack and that Gallop thing which is suppose to be a sign of or heart failure.  EKG's after that one all came out normal, and so did all the other tests.

I would not freak out yet but would make an appointment with a Cardiologist.  

As for the hypertension, I inherited it too, both my parents and my grandmother had high BP, my grandmother had what they call "malignant hypertension", very, very high, that was before BP meds.

[bellick]

I will be going for a proper review with my doc soon. My doc thinks that I may have genetic hypertension. He recommended that I reduce my salt intake for the time being while waiting for the urine test results (testing for Pheochromocytoma).

My doc knows abt my family history of hypertension. But what abt my abnormal ECG results? It indicated a sinus rythmn and right axis deviation which meant pulmonary disease pattern with RVH. It also indicated 1st degree AV blockage. With my normal Echocardiogram results, that does not seem to fit into the picture? Any explanation?

Thanks. Cheers.

[Barbarella]

If you had white coat hypertension you would have anxiety BEFORE every BP reading at a doctor's office/hospital or even at home.  You would have the "what if"  "will my BP be high", what if, what if.

What did your doctor say?  What does he/she think is the case with your BP?

I'd say you are pre-hypertensive because of your family history AND because the new guidelines are if your BP is over 120/80 you are considered "pre-hypertensive".

I'm surprised that your doctor did not at least suggest diet/life style changes since they are so hyper now a days if your BP is over 120/80.  But it looks like the Cardiologist in your case was not concerned.  He ran all the tests which I came out normal and that is good.

Does he/she know about your family history of high BP?