Question 1

My brother is 18 and we've discovered that he has high blood pressure readings around 14070 or sometimes 15070. We've done a bunch of tests like ECG, EKG, ultrasound, renal Doppler, TSH, echo, and urine metanephrine serum tests, and they all came back normal. The doctor mentioned something about essential hypertension and started him on amlong 2.5mg. But since that didn't help, his dose was bumped up to 5mg. I just got a BP monitor, and his readings were 13078 in the morning and 14770 in the evening. I'm seriously concerned because he's so young and is managing to exercise regularly with a healthy BMI. What could be causing this, and how can we help lower his BP?

Accepted Answer

It's good that your brother has been proactive in monitoring his blood pressure and leading a healthy lifestyle. Despite these measures, essential hypertension can sometimes be challenging to control. Since the morning blood pressure reading is within a normal range, it's important to continue monitoring at different times of the day. In cases where blood pressure remains elevated, the dosage of the medication may need to be adjusted further. I recommend discussing with the doctor about potentially increasing the dose of Amlong to 7.5mg or exploring other medication options such as Telma (Telmisartan) 40mg. Additionally, lifestyle modifications such as reducing salt intake, maintaining a healthy diet, regular exercise, and stress management techniques can also help in managing blood pressure levels. Regular follow-ups with the doctor for monitoring and adjustments are essential in managing hypertension effectively."

Question 2

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 3

I'm 36 years old and my cholesterol levels are quite high. I've got the details here: Total cholesterol is 212 mgdL, triglycerides are 333 mgdL, HDL is 33.60 mgdL, LDL is 143 mgdL, VLDL is 35.4 mgdL, and Non-HDL is 178 mgdL. My liver function tests show bilirubin total at 0.42 mgdL, bilirubin direct at 0.07 mgdL, and bilirubin indirect at 0.35 mgdL. My SGOT is 40 UL, SGPT is 34 UL, GGTP is 28 UL, ALP is 121 UL, total protein is 7.20 gdL, and albumin is 4.48 gdL with an AG ratio of 1.65. My fasting blood sugar is 102 mgdL. The doctor recommended taking Rozavel F 10 mg twice a day, but I'm really concerned and wondering if there's anything else I can do to lower my cholesterol quickly. Any advice or tips would be greatly appreciated.

Accepted Answer

"Based on your cholesterol levels and liver function test results, I recommend adding Ezetimibe 10 mg once daily to your current treatment with Rozavel F 10 mg twice a day. This combination can help in faster reduction of cholesterol levels. Additionally, you can consider adding Omega-3 fatty acids supplement to further improve your lipid profile. Make sure to follow a healthy diet low in saturated fats and engage in regular physical activity to complement the medication therapy."

An ecg and psychiatric opinion for anxiety is advised to the patient..

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