Question 1

I've been dealing with hypertension for the past year and recently found out I have mild LVH. I'm currently taking nebivolol and amlodipine, but my blood pressure still won't go below 13585. I'm only 34, and I'm worried about why these meds aren't working. Is there something else I should consider doing or trying?

Accepted Answer

Managing hypertension with mild LVH (Left Ventricular Hypertrophy) requires a comprehensive approach.

_Current Medications_

1. _Nebivolol_: A beta-blocker that helps lower blood pressure and reduce LVH.
2. _Amlodipine_: A calcium channel blocker that helps relax blood vessels and lower blood pressure.

_Additional Strategies_

1. _Lifestyle Modifications_:
    - Regular aerobic exercise (at least 150 minutesweek)
    - Weight management (aim for a BMI between 18.5 and 24.9)
    - Balanced diet (emphasize fruits, vegetables, whole grains, and lean protein)
    - Stress reduction techniques (meditation, yoga, or deep breathing)
2. _Monitor and Adjust Medications_:
    - Regularly monitor blood pressure and adjust medications as needed.
    - Consider adding a diuretic or an ACE inhibitorARB to enhance blood pressure control.
3. _LVH Monitoring_:
    - Regular echocardiograms to monitor LVH progression
    - Adjust medications and lifestyle modifications accordingly

_Consult a Specialist_

Consider consulting a cardiologist to reassess your treatment plan and provide personalized guidance.

Question 2

I'm a bit worried about my 65-year-old relative who recently had an angiography, and it showed they have about three blockages in the 70-80% range. We're not totally sure about the accuracy of the angiography report we got, so I'm wondering if it's possible to have another angiography done. If so, how long should we wait between the two procedures? Also, could doing a repeat angiography pose any risks or problems for them?

Accepted Answer

Repeat angiography can be done if there are doubts about the initial report. The interval between two angiographies is usually around 6-12 months, depending on the patient's condition and the recommendation of the treating physician. Repeating angiography may pose some risks such as contrast-induced nephropathy or allergic reactions, but these risks are generally low and can be managed by the medical team.

Question 3

I'm really worried about my heart rate. I was prescribed Propranolol 20 MG for anxiety and palpitations by my cardiologist, but when I started feeling uncomfortable with light chest pain, I went to another cardiologist who told me to stop taking it. So I did, and I felt normal for a day, but then my heart rate jumped from 85 sitting to 145 standing the next day. I'm scared to go to the hospital because my heart rate might increase even more. If it's already at 140 just standing, I can't imagine how high it would go while working. Is this something very serious? Also, my blood pressure at night was 130 after eating and 127 before eating while I was on the medication, but it hardly ever went over 120 before all this. If just two days of using Propranolol caused these withdrawal effects, how am I supposed to handle this medication for the long term? I'm living in constant fear of dying. Can you help?

Accepted Answer

It sounds like you are experiencing significant anxiety and palpitations along with withdrawal effects from Propranolol. The sudden increase in heart rate upon standing is concerning and may indicate a condition called orthostatic intolerance. This needs to be evaluated further by a healthcare professional. To address your symptoms, you can try the following: - Discontinue Propranolol under medical supervision to avoid withdrawal effects - Practice relaxation techniques such as deep breathing or meditation to help with anxiety - Stay well-hydrated and maintain a healthy diet - Avoid sudden changes in posture to prevent orthostatic intolerance In the meantime, it is important to consult with a cardiologist or a healthcare provider for a proper evaluation and management plan. They may consider alternative medications or therapies to help with your symptoms. Remember, sudden changes in heart rate and chest discomfort should not be ignored. Take care.

I've been keeping an eye on my blood pressure, and it was reading 14496 when I saw a doctor. He told me to take Telma 20 for six weeks, which I did, but now I can't get back to see him. This morning, my BP was 13496. What should I do next? Do I need to keep taking the medication or make any changes?

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