Hello,
To give some background, I (32M, 5'9", 170 lbs, no prescription medications) have had elevated blood pressure readings since I was a teenager, despite being normal weight, eating relatively well, and being a former distance runner. In medical settings, I get nervous and tend to get systolic readings of 150+. At home, my readings tend to be considerably lower, but still at least in at least the prehypertensive range--usually in the 130s to low 140s. Based on this, doctors in the past did not think the problem was severe enough to require medication, so I have never been medicated despite having elevated readings for a long time.
Recently, I became concerned about bubbles/foam in my urine, and saw a cardiologist to make sure I didn't have any kidney or other damage from high blood pressure, and to re-evaluate whether I might need medication. He ordered blood, serum, and urine tests; an EKG, and a 24-hour ambulatory BP evaluation. Based on these results, he said everything was working fine and I didn't need medication at this point.
However, when I went home and actually looked at the labwork, there were a few items that I still have concerns about:
Urine: pH was 8.5, which I read is unusually high and can indicate kidney damage in some cases. Trace amounts of urobiligonen. Tested negative for protein, but I don't know if that's something that can return a false negative because I ate no protein that morning or drank a lot of water.
Serum: Albumin was 5.2 g/dL, at the upper end of the reference range. Globulin was 2.2 g/dL, just under the reference range, so A/G ratio was 2.4.
Creatinine: SCr was 1.06 mg/dL, near the upper end but still within the reference range. However, as far as I can tell, this reference range is age-independent. Using the MDRD equation, this works out to an eGFR in the ~85 ml/min/1.73m2 ballpark, which still suggests mild damage. My kidneys may still work fine now, but being only 32 and having elevated BP, they still have a lot of time to go downhill. Is this score acceptable for a 32-year-old even though it's within the reference range?
I know I worry excessively about my health, but I'm still concerned that having elevated pressure for so long might have caused some damage, and I want to nip it in the bud if that's the case. Based on the above, do you think it's worth it to get a second opinion regarding hypertension medication? Thanks so much!