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Old 02-16-2009, 08:54 PM   #1
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Should I be seeing a Cardiologist about my High BLood Pressure?

I am a 32 year old female who has had high blood pressure for at least 10 years. The doc can find absolutly no reason for me to have it. I am currently taking Lisinopril/HCTZ which was perscribed by my reg. Dr. I have been on numerous meds and they work for awhile then quit working as well and the Dr. changes it.
I don't know why but I have been getting dizzy spells lately off and on, no rhyme or reason to when I get them. My mom has been all over me lately to see a Cardiologist and I am really beginning to wonder if maybe I should go see one....Anyone have any input?

 
Old 02-16-2009, 09:42 PM   #2
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Re: Should I be seeing a Cardiologist about my High BLood Pressure?

You are a 32 year old woman with high blood pressure? If your family doctor is treating your high blood pressure with medications only and has done no other investigations then yes, you need to be seen by either a cardiologist, or more appropriately a general internist.

High blood pressure or Hypertension is in the majority of people from having stiff blood vessels which happens with age. This is known as essential hypertension and makes up 90% of all hypertension; HOWEVER, there are certain other conditions which can cause hypertension as a result of the disease process or anatomic abnormality. These types of things MUST be ruled out--especially in people in whom you don't generally expect to see hypertension (like in a young woman like you) or in someone where they don't seem to be responding to the antihypertensive pills.

In your case, being a young woman, you DEFINITELY need a work up to rule out secondary causes of high blood pressure. These include:

ANATOMIC ABNORMALITIES:
Fibromuscular dysplasia (a "common" cause of secondary hypertension seen in young women)
Renal artery stenosis (which may or may not be related to the first cause I listed)
Coarctation of the aorta.

METABOLIC Problems
Hypercalcemia (high calcium in the blood)

ENDOCRINE
Hyperparathyroidism (which can cause the high calcium)
Hyperthyroidism
Pheochromocytoma
Conn's Disease (adrenals secreting too much aldosterone)
Cushing's Disease or syndrome (too much cortisol secretion)

KIDNEY RELATED
Any renal disease can result in high blood pressure

HEART RELATED
Hypertrophic cardiomyopathy (early stages)
High output cardiac failure (Paget's disease, large arteriovenous malformations)

These types of things need to be ruled out by someone who has experience in dealing with rarer causes of high blood pressure and a family physician is NOT that type of doctor. You need specialist help.

 
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Old 02-17-2009, 05:19 AM   #3
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Re: Should I be seeing a Cardiologist about my High BLood Pressure?

I guess I should of mentioned that the doctor I do see is an internal medicine dr. and he does draw blood about every 6 months to check kidney function and I assume other things. My mom has never liked the guy and has been all over me lately to see a cardiologist to "look into things" and can't believe he hasn't referred me to one already. Looking at all these things that could be ruled out and "looked into" I can't believe he hasn't either. All these cannot possibly be checked by bloodwork. I feel like an idiot.

I will look into this today. Thanks for the response.

 
Old 02-17-2009, 07:28 AM   #4
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Re: Should I be seeing a Cardiologist about my High BLood Pressure?

Hi there,

Have you gotten any imaging done? i.e. an MRI of your renal vessels or a renal doppler scan? Much of the other stuff CAN in fact be investigated through blood. Perhaps it would be a better first step to ask him what investigations have been done for secondary causes of hypertension. If none of them have been done, they should be.

 
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