How to manage essential hypertension for a long time

Posted by wangning @wangning, Dec 9, 2022

I am 26 years old, and in my physical examination this year, I found that my blood pressure increased, high pressure 190, low pressure 150. Went to the hospital for a cardiogram, brain MRI, kidney CT, dynamic electrocardiogram, blood routine thyroid function, these tests were in the normal range, but one test showed vascular sclerosis, and the hospital recommended lifelong medication. I want to know how to manage blood pressure for a long time and worry about the side effects of long-term drug treatment.

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@wangning – I can certainly understand your concern about side effects of long term medication treatment. I've been on several different high blood pressure medications for over 40 years. Back in my 50s I was fortunate enough to be involved in a Mayo Clinic heart study. As a result my diagnosis changed to hypertension caused by primary hyperaldosteronism and my medications were changed to spironolactone – 25mg and hydrochlorothyazide – 25mg. I've made some lifestyle changes since then to help control the hypertension and possibly get off the meds but I don't think that will happen for me but I'm still doing what I can do to help the condition. Here's some information on the topic that you might find helpful.

— Management of Essential Hypertension:
https://www.sciencedirect.com/science/article/abs/pii/S0733865116301370
Have you discussed how you can better manage your hypertension with your doctor?

REPLY
@johnbishop

@wangning – I can certainly understand your concern about side effects of long term medication treatment. I've been on several different high blood pressure medications for over 40 years. Back in my 50s I was fortunate enough to be involved in a Mayo Clinic heart study. As a result my diagnosis changed to hypertension caused by primary hyperaldosteronism and my medications were changed to spironolactone – 25mg and hydrochlorothyazide – 25mg. I've made some lifestyle changes since then to help control the hypertension and possibly get off the meds but I don't think that will happen for me but I'm still doing what I can do to help the condition. Here's some information on the topic that you might find helpful.

— Management of Essential Hypertension:
https://www.sciencedirect.com/science/article/abs/pii/S0733865116301370
Have you discussed how you can better manage your hypertension with your doctor?

Jump to this post

Is your advice to continue to identify the cause?
I have no family history, no underlying diseases.

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@wangning

Is your advice to continue to identify the cause?
I have no family history, no underlying diseases.

Jump to this post

I'm just a patient like yourself and can't give medical advice. If it were me, I would want more information on treatments available for my condition and/or what kind of lifestyle changes can I make to help the condition and reduce the risks involved. It really is helpful to be your own advocate when it comes to your health. You might find the following site helpful for working with your doctor or care team:

The Patient Revolution
— Tools for the Visit: https://patientrevolution.org/visit-tools
— Communication Barriers: https://patientrevolution.org/barriers

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@wangning

Is your advice to continue to identify the cause?
I have no family history, no underlying diseases.

Jump to this post

Hi, do what ever your doctors tell you to do but also consider the following.

Get a BP cuff and track it at home at the same time every day, after resting for 5 minutes with feet flat on floor (look up other things). The blood pressure cuff you get at home can have blue tooth and sync to your phone for reports and tracking.

Reduce sodium

If you want to get super serious about lifestyle look up Dr. Dean Ornish and people like him.

With your doctors, Manage it if it gets that high often (med's or lifestyle or both) , don't ignore it or it may lead to a more serious issue/event you don't need that is preventable, when you are older, or if it gets higher.

If you get a good internal medicine doctor they may be able to guide you and serve as your primary doctor possibly if helpful. Or a Cardiologist if you want more answers or to review your test results/reasons/actions related to what you noted "vascular sclerosis".

Don't stress but take action, you have the information and age on your side. You may find it goes back down if you do a few minor things.

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