Isolated Systolic Hypertension @ 23 yrs old - High & Low Blood Pressure Message Board

alptraum · 01-27-2005, 03:21 PM

What could cause Isolate Systolic Hypertension in someone in their 20's? When looking around the web all I find is talk of it involving the elderly with stiff veins.

On a few sites they described ISH as being a "discrete pathological entity", what does that mean?

It seems the BP in the right arm (higher of the two) sits around 137-142/66-74 @ 68-74 bpm. How long can I run with numbers like these? I've had this problem for about 2 years now. I used to have chest pains but all the docs said my bp was not high enough for it to be cardiac related. University docs wanted to put me on meds (HZT made my BP and BPM go up) but when I went to the Mayo they didn't want to stick me on anything yet.

Out of all the tests I've had done, all they have found is low testosterone, which I have had checked twice to verify the first result. Could getting my testosterone back within normal fix things? Total testosterone was like 187 (normal is like 250+) I'm almost to the point of going to the doc and asking them to give me a test injection. I'm actually on the low end of the BMI scale, I could stand to gain 10-15 lbs in fact.

I'm 3 months away from graduating graduate engineering school and getting my masters has definately been twice as hard as it would have been if I had been healthy. Once I get out of school I'll actually have money to go to the doc again and see if they can fix me up.

Palamedes · 01-28-2005, 10:00 AM

Well, first off your diastolic is fantastic. I assume these numbers are taken in a home relaxed setting? Anxiety normally has a huge influence on the systolic. I have to agree with Mayo about treating this. The problem is that when you treat the systolic, you are going to be "treating" the diastolic. There isn't a lot of room to work with here. Another thing you've learned is that HCTZ caused your BP to go up. And, your systolic isn't really that bad to begin with.

Are you eating a low sodium diet? Or, are you simply not eating enough? The low BMI and your reaction to HCTZ sorta points me in that direction. What could be happening here is that you are volume depleted already. And your renin-angiotensin system is in high gear. This would explain the reaction you got to HCTZ. Since, HCTZ raised your BP, guess what the opposite of HCTZ is? Eat more salt (though, I have a hard time recommending this). Of course, if you were to try a drug in the future, an ACE inhibitor or ARB would be the most logical choice. Again, I don't recommend drugs based on those numbers.

I had never researched anything about testosterone and BP. I was quite surprised to learn that there appears to be a relationship between testosterone levels and BP. And, the relationship is the exact opposite I would have guessed. However, it seems there is some chicken/egg stuff with it. Does high BP cause low testosterone? Or, does high testosterone lower BP?

Pal

alptraum · 01-28-2005, 10:36 AM

Actually I've had my diastolic at times drop to 57-60. Also what is weird is sometimes I will get good numbers, like this morning I measured 102/64 @ 67 when I first got up in the morning and I tested both arms and waited 10 min and did it again in the right to make sure it was not a fluke.

Yeah that is one reason I told the university docs to screw off when they wanted to put me on anything other than hzt, my diastolic is low enough and I'd fear I'd have problems from having too low of a diastolic.

What's the renin-angiotensin system that you speak of?

Actually I'm vegetarian, for the last year have been rather hardcore but starting to soften up and starting to eat meat again since I have such a hard time maintaining body weight. The more I think of it I think I have a hard time getting enough calories though. Also in the research I've done it looks like being vegetarian can cause low testosterone problems in certain people, so I might back off for a while and see if I can't get total test back up.

Palamedes · 01-28-2005, 07:51 PM

Quote:

Originally Posted by alptraum

What's the renin-angiotensin system that you speak of?

Basically, it's a feedback mechanism. Your kidneys produce renin when they detect low BP. Through a chain of enzyme/hormone reactions, this ends up causing vasoconstriction which increases BP. For some, low sodium diets (or taking HCTZ) can actually increase BP as this system over-compensates. This feedback mechanism is designed to regulate your BP to be the same no matter what level of sodium you are consuming. An ACE Inhibitor or ARB breaks this feedback allowing your BP to fall when you restrict sodium or take HCTZ.

Pal