20 years old and high blood pressure? - Please Help!

[nospin06]

Greetings everyone,

I just turned 20 this month and am currently a sophomore in college. I went in for a checkup recently (I haven't been to a checkup since 2000!) and discovered that my BP is high for a person my age. My right arm registered at 165/70 and left arm was at 150/70. In terms of my physical condition, I am 5'6'', 160 lbs. I played football in highschool and weight training has been a part of my workouts since. I consider myself to be pretty fit and in good health. In terms of my diet routine, I try to stay away from junk and fatty foods. I always opt for a salad or a subway sandwich instead of a slice of pizza.

My doctor put me on hydrochlorothiazide 12.5mg taken twice a day, and I've been using the drug for about 5 days now. I have an appointment with a cardiologist tomorrow for an evaluation.

I'm worried about having high BP at such a young age. Could it be attributed to the fact that I am usually pretty stressed out? Schoolwork and my part-time job pretty much occupy most of my days, and also stress me out at times. What could the reason be?

Any help will be appreciated. Thank you.

[wr6969]

Hi there nospin. Your doctor was right in saying that for someone your age, your BP seems to be high. I've noticed that only the systolic number is high, while the diastolic looks good! I wonder if you've done some research on a phenomenon called "isolated systolic hypertension" to find out what exactly this is, and what contributing factors are to this condition.

Your doctor has also started you on what is commonly referred to as the "water pill" - normally the first line of defence against hypertension, and normally prescribed by doctors with a "conservative" approach to treating it. I think the main purpose of this drug is for you to visit the toilet more often, purging any (mainly) excessive salt from the body, which contributes to hypertension. However, it can also lower potassium levels to potentially unsafe levels, so it's always safe to do some blood tests to determine its effects on the potassium levels in your body. Having said this, there are now potassium sparing HCTZs in the market.

A couple of questions come to mind:

(1) has your doctor asked you about family history of heart disease or hypertension? Hypertension is unfortunately a family 'heirloom" that you can't escape from!

(2) has your doctor investigated other underlying causes for your condition? Have you recently done a full blood examination?

(3) were you having an illness when you visited your doctor? Common ailments like the cold and flu has been known to increase BP!

(4) has your doctor ruled out "white-coat" syndrome where a patient is terrified of having his/her BP taken in a doctor's environment, freaks out thereby causing his/her BP to rise unnecessarily? One method to ensure this is not the case is to buy a BP monitor and take measurements at home. Bear in mind that BP fluctuates throughout the day, so you won't get constant readings; hence the need to perhaps jot down on a piece of paper the time and BP numbers for recording purposes to show it to the doctor if required. You'd probably want to take your pressure upon waking up, after lunchtime, and before going to bed as a minimum.

Stress has been known to increase your BP numbers, along with a state of anxiety. However, it is normally both numbers that are affected, ie. the systolic and diastolic, whereas in your case, only the systolic is elevated.

[zuzu8]

Hi Nospin-
WR6969 asked some great questions, and the answer to question #2 is very important. When someone your age presents with hypertension it is critical that your doctor rule out secondary causes. A complete blood panel would be basic. And possibly scans of kidneys and adrenal glands to look for benign tumors which can elevate the BP. Note I said benign... So don't panic at the word tumor!

Were you put on the meds after only one visit to the doctor?
A one-time elevated reading is no justification to put you on HCTZ. Your BP should be monitored over several weeks before a diagnosis of true "primary" hypertension can be made.
I would be curious to hear what the cardiologist has to say, and what further tests he/she wants done for you.

zuzu xx

[nospin06]

Originally Posted by wr6969

Hi there nospin. Your doctor was right in saying that for someone your age, your BP seems to be high. I've noticed that only the systolic number is high, while the diastolic looks good! I wonder if you've done some research on a phenomenon called "isolated systolic hypertension" to find out what exactly this is, and what contributing factors are to this condition.

- I am not familiar with that particular case of HBP, but I hope to find some answers when I visit the cardiologist today.

Your doctor has also started you on what is commonly referred to as the "water pill" - normally the first line of defence against hypertension, and normally prescribed by doctors with a "conservative" approach to treating it. I think the main purpose of this drug is for you to visit the toilet more often, purging any (mainly) excessive salt from the body, which contributes to hypertension. However, it can also lower potassium levels to potentially unsafe levels, so it's always safe to do some blood tests to determine its effects on the potassium levels in your body. Having said this, there are now potassium sparing HCTZs in the market.

A couple of questions come to mind:

(1) has your doctor asked you about family history of heart disease or hypertension? Hypertension is unfortunately a family 'heirloom" that you can't escape from!

- Yes, my grandfather had HBP and I believe my uncle does too at the moment. My dad on the other hand seems to be fine (130/70).

(2) has your doctor investigated other underlying causes for your condition? Have you recently done a full blood examination?

- My last blood test was back in 1999. Everything was fine, cholesterol levels, etc. However, I had my BP check back in 2000 and it was high as well (150/70), and that was when I was in the best shape of my life during the football season.

(3) were you having an illness when you visited your doctor? Common ailments like the cold and flu has been known to increase BP!

- I was not sick or ill at the time.

(4) has your doctor ruled out "white-coat" syndrome where a patient is terrified of having his/her BP taken in a doctor's environment, freaks out thereby causing his/her BP to rise unnecessarily? One method to ensure this is not the case is to buy a BP monitor and take measurements at home. Bear in mind that BP fluctuates throughout the day, so you won't get constant readings; hence the need to perhaps jot down on a piece of paper the time and BP numbers for recording purposes to show it to the doctor if required. You'd probably want to take your pressure upon waking up, after lunchtime, and before going to bed as a minimum.

Stress has been known to increase your BP numbers, along with a state of anxiety. However, it is normally both numbers that are affected, ie. the systolic and diastolic, whereas in your case, only the systolic is elevated.

- I certainly was a bit nervous; hopefully my visit to the cardiologist will provide some answers and good news.

Thanks wr6969 for your help! I will provide an update once I get back from the cardiologist today.

[pslam 91]

Hi, just to add to that. My husband and I work with a lot of youth through church activities. We notice that young people can drink ALOT of caffinated drinks without batting an eye. (and suger products) We have seen young boys drink too many "Mountain Dews"(very high in caffiene) when away from their parents.
Also, cold, flu and allergy remedies can also elevated your blood pressure.
My point being, watch your intake of foods and meds and see if that may be effecting you. And YES!!! Stress can effect your b/p! Take it easy, and try not to push yourself too hard. See where you can cut back on semester hours or work hours etc. After you give yourself a season of evaluating your lifestyle, then see about meds. Bless you!