22 y/o male with a hypertensive high score of 190/111

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I'm a 22 year old male. Without meds, my blood pressure probably averages around 150/85 or so. On several occasions I have received readings that would be considered hypertensive crisis, the highest I remember being 190/111 after I had gone off of my meds for a week or so (simply due to carelessness on my part). I will note that these excessive readings have been taken in the clinic, and not by me. This concerned my GP enough that a couple years ago, she ordered a gamut of tests including a cardiac ECG, stress test, and ultrasound. All came up normal, despite my reaching the stress test's target heart rate of 180 bpm in 2 minutes with barely any effort.

The hypertension seems relatively well controlled on 10mg/day lisinopril. I'm kind of stumped here. I know that primary hypertension is a thing, and a common one at that, but I still worry. I'm going to list some other symptoms i've consistently had and possible contributing factors; if anyone can give me literally any shred of insight it'd be hugely appreciated. It kills me that they can't find anything wrong with me beyond this.

BACKGROUND/POTENTIAL CONTRIBUTORS

-22 year old male, 5'11, currently 230 lbs but active. I've struggled to lose weight and keep it off since childhood.

-Hypertension found when I was 19; 200lbs at the time

-LDL 103 mg/dL, HDL 80 mg/dL (yes the HDL is correct, it's extremely high for whatever reason)

-High sodium diet (college student) , but a month of salt restriction didn't reduce the BP numbers

-10mg/day lisinopril seems to control BP well, but I should check more regularly at home to make sure this is consistent

SYMPTOMS

-long standing poor cardio endurance, even when BMI was normal and I was playing several hours rigorous high school sports on a daily basis

-frequent nausea/vomiting after intense exercise

-frequent headaches

-almost always tired, even after 12 hours of sleep

-Seemingly random spells of severe nausea, often with cold sweat

-Recurrent sinus issues and GI troubles, if that matters

FAMILY HISTORY

Hypertension (Father&Mother) (not nearly as high as mine despite their being in their 60s), obesity (F&M), Type 1 diabetes (F), heart disease (F)

1 like, 15 replies

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15 Replies

  • Posted

    What does the doctor say about your digestive issues? Have you seen a gastroenterologist and been checked for fatty liver or gall bladder problems?  Have you ever been checked for Epstein Barr virus due to your fatigue? Try to check your BP at home once a day after sitting quietly for ten minutes..do this for a couple of weeks and keep a log with dates and times. Then you can present this to a doctor.

    It cant hurt to eliminate sodium and processed foods and try a diet with very low fat. The McDougall diet seems to help many people lose weight and lower BP. Good luck.

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  • Posted

    Dear Snowshine,

    ?You're very Young so everything is pretty much in your Favor IF you can get motivated to do what is necessary to correct and preserve your health.  Since You are familiar with the BMI, You are aware that you are more than overweight.  Yeah, I know.  We don't like to hear the words "Obese and Morbidly Obese" - but unfortunately, You're there.  But you can fix it!  Slow as You Go is the Key!  At 230, it should be fairly easy to drop 1 - 2 pounds per week with diet alone.  If you're pretty much currently sedentary, You can calculate how many calories are required to maintain the 230 pounds. I suspect you can reduce your daily Caloric Intake by 500 Calories per day probably by doing Nothing but removing ALL  Beverages except Water.  500 Calories per day less - times 7 days per week - equals 3500 Calories or ONE POUND Loss per Week!  It Works!  I did it.  And I continue to do it.  Do you eat Sweets?  I did.  I was certifiably addicted to Sweets!  Loved them!  (Still do but I finally managed to refuse them entirely!)  A single Candy Bar of Slice of Cake or Pie can easily contain 500 - 1500 Calories!)

    ?The reason I'm focusing on weight loss first is I see You're tired and apparently don't feel like exercising much right now.  That's OK!  Pick Up TWO 25 Pound Bags of Potatoes and try to walk with them for a ways.  Also, Lisinopril can make some people somewhat lethargic.  But when you get about 10 pounds off, if determined, you can start walking/strolling 10 - 15 mins per day.  Now, things will start to Pick Up.  Between the weight Loss and gradually working exercise in, I highly suspect you will start feeling better Physically AND  Mentally.  I'll bet you're struggling with some Anxiety and/or Depression.  Being Overweight, a Student, Exams, Poor Diet, Stressing over a lot of things, your High BP doesn't surprise me.  But as I said at the beginning, Everything REALLY IS Your Favor!

    ?Get Started.  DON'T take your BP more than Twice per day!  And DON'T take it first thing in the Morning.  Everyone's BP Raises as you wake up.  It's PART of the awakening Body Process.  And don't take it within one hour of drinking Coffee or Tea - or any Caffeinated Beverage!  And avoid at all costs "Energy Drinks"!  Enough Caffeine for a horse to win the Kentucky Derby!

    ?You're going to be fine!  But I firmly believe everything you listed contributing to your issues are under your control!  Go for it!  I'm rooting for you!  Keep us Posted regarding your progress!  Good Luck!  Ernie.

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    • Posted

      Good reply Ernie!  Keep it SIMPLE Snowshine.  Relax; stop fretting and jerking your anxiety chain.  You are in control.  Drop the snacks and booze.  Get walking or jogging.  Add some exercises and weights.  Check out the local health clubs or look on youtube for an exercise video or two, three...that motive you.  Blood pressure charts have changed, probably to sell more prescriptions - who knows really.  Pharmaceutical companies and physicians climbed into each other's beds a while ago.  10 mg of that lisinopril is very low.  BTW lisinopril has a rotten reputation for crappy side effects!  You might want to use that as your goal to dump some pump.  Get off the BP meds, especially at your age.  You can do if you suck it up and get it done!  Good luck!!

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    • Posted

      Great lifestyle advice here. When I weighed about 180, and was trying to lose that last 20 lbs or so, I was eating around 1200 calories a day with exercise. Unfortunately, that basically resulted in my metabolism shutting down and my barely being able to function on a day to day basis. I simply could not lose any more weight with what I was doing, and I gradually reverted to bad habits over the next 3 years, which brings us here lol.
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    • Posted

      Dear Snowshine,

      ?Quit "Beating Yourself Up" and just start doing the things you know you need to do.  And Yes, at 1200 Calories per day - which is considered the Absolute Minimum for an Adult Male - You will suffer exhaustion!  Once again, there are some Great Sites on the Web such as Web.MD and others where you can Calculate how many Calories GENERALLY required for Sedentary, Moderately Active, Very Active, etc.  I say "Generally" because everyone's Metabolic Rate is somewhat different.  Without leaving this Forum at the moment and Googling it - from memory - 1200 Calories will only support a 140 pound SEDENTARY Male.  But Please verify this.  Don't Waste your Life Fretting and Worrying about Negative things that probably will NEVER HAPPEN!  I'm not suggesting you go through Life "Careless and Carefree" - but enjoy yourself and keep things in perspective.  Once again, the Best to You!   Ernie

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    • Posted

      There is a happy medium you know! 1200 calories a day is completely unsustainable for an active young man of your size, as you found out. No wonder you were exhausted. The average calorie requirement for an adult male is 2,500 and you shouldn't go much below that. It would be unwise to go too far above either, unless you're really exercising hard, in which case you'd need more.

      These days there's been a move away from calorie-counting as a way of losing weight, with more emphasis on the type of calories you consume. Dietary fat was demonised for many years - though I never bought into that one - but now we know it's carbs that pile the weight on.

      The worst of the carbs is sugar, especially the refined type that's found in sweets, cakes, pastries and junk foods - including, somewhat surprisingly, the savoury kind. This is because sugar has a high glycaemic index. (Google it if you don't know what it is.) The highest GI sugar of all is the high-fructose corn syrup that's found in most junk foods. And don't forget sweet drinks. These generally have an even higher GI, as sugar taken in this form gets into the bloodstream faster.

      Natural fruit sugars are OK, but in moderation. It's best to avoid fruit juices, even the unsweetened kind, for the same reason as above - the sugar gets into your bloodstream faster that way. Preparing fruit in the form of smoothies improves things slightly, but the chopped-up fibres still release sugar into your bloodstream quite fast. The best way is to eat two (maximum three) pieces of whole fruit per day.

      Carbs also come in the form of starchy foods like bread (especially the white kind), pasta, rice and potatoes. This means you need to be careful with these foods too, though you need some carbs to give you energy.

      Fats - even the saturated kind - are fine, in the form of dairy and meat, and oily fish, which largely contains unsaturated fats, is good for just about everything. Ditto olive oil. The only fats you should avoid like the plague are the transfats in junk foods, commercial baked goods etc. - and which you also manufacture in your own kitchen if you re-use frying oil! These are frankly toxic for every system in your body.

      As Ernie says, none of the above means you have to live like a hermit, depriving yourself of all treats. The occasional pizza or chocolate bar won't hurt, nor will a couple of cans a beer a week.

      Finally, take it slowly. Don't go for an immediate, visible weight loss - the "burn" that W**ght W****ers are so enamoured of. (I'm trying to stay under the radar here!) There are a lot of scientific articles out there that say this doesn't work long-term, and may even be counterproductive. There are too many accounts of "Slimmers of the Year" being interviewed five years down the line, and turning out to be heavier than they were when they started out. So don't look for fast results.

      Take your prescribed medication regularly, which is particularly important for BP meds, be a bit careful about what you eat, and take a reasonable amount of exercise without going completely over the top. I'm sure you'll be fine!

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  • Posted

    BTW, Snowshine,  Veewat mentioned something I meant to address.  Before my weight loss, I had digestive issues and Fatty Liver.  You may be amazed how resilient the body is.  Losing weight allowed my Liver to fix itself and I no longer have a Fatty Liver.  Do you drink alcohol at all?  If so, it basically goes directly to the liver!  Stress can cause all kinds of digestive Issues.  And yes, Veewat is correct.  If your Digestive Issues are significant, You may wish to discuss various Tests with Your MD.  At your age, I developed Colitis. It was brought on strictly due to Anxiety and Stress.  There are some Meds to help with these issues.  But be careful.  If prescribed, decide for yourself up front that they are TEMPORARY!  They can be addictive and generate an entirely different set of Issues!  Once again, Good Luck!  Ernie
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    • Posted

      My digestive issues are also largely unsolved, but come and go. I know I have pretty bad acid reflux; weight loss will resolve part of that if not all. I did have a colonoscopy and had numerous benign polyps, but was never diagnosed with anything definitive.
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  • Posted

    I greatly appreciate all of the responses. I agree losing weight and eating better will help immensely. I have lost well over 100 lbs cumulatively as an adult, so I'm well aware of what it takes. I think the most recent weight gain back into the realm of obesity can be attributed at least partly to starting antidepressants and quitting nicotine at the same time. I do not drink except very occasionally.

    My worry is not losing weight, that I know I can do with some dedication and I know it will help. My worry is that there is an underlying cause to this that needs to be addressed. I don't think this is an unreasonable possibility, as my levels are EXTREMELY high for someone my age and even my BMI.

    Also do note that I do not meet, or come close to meeting the diagnostic criteria for any kind of anxiety. My inner demon is depression. This is not to say I don't ever stress, but I am fairly relaxed most of the time, so I doubt that is much of a contributor to the hypertension.

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    • Posted

      Hmph, Snowshine49.  You appear to keep cycling here.  Over-analyzing.  Who told you the readings are "EXTREMELY high...?"  Are you being treated for depression?  Therapist?  Rx?  Do you have hobbies, friend(s) to hang out with/talk with/do stuff?  Do you have family/siblings, significant other, dog, cat, pony, etc. to speak to, spend time, hang out with, do some enjoyable things with and stop fixating on finding something wrong with you?  If no, how about Meetup.com to find a group with similar interests to join?   GOOD LUCK

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    • Posted

      I'm medicated. I do not sit around and focus on what may be wrong with me, look up various types of obscure and rare cancers that may match my symptoms, etc. I simply feel like I have not received satisfactory answers so I decided to do research so I knew how to ask the doctors to paint a bigger picture for me. Additionally, my degree is in biomedical engineering and I am attending medical school next spring. No, I am not yet a doctor, but I feel qualified enough to have concerns.

      I know you're well meaning, but please don't imply to a depressed person that their illness boils down to lack of a social life or hobbies. I lead a very fulfilling life in both of these areas. Depression is a mental illness: not a mood, a funk, the blues, or anything else. It's frustrating when people minimize, isn't it?

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    • Posted

      Dear Snowshine,

      I sincerely hope NONE of my Posts offended, dismissed or belittled your problems or concerns about your Health Issues.

      As someone who has suffered from Anxiety and Depression his entire life, I'll be the first to say - "No One can really Relate unless they've BEEN THERE"! And for those who would say "Just Shake it Off" - Karma can be Brutal!

      I truly hope some of my responses have been of at least a little help.

      I hope you improve Immensely in the very near future. And I feel if you become a Physician you will have not only insight but true compassion and empathy for those who come to you seeking help - especially in one of the most misunderstood areas of our health - Anxiety and Depression.

      Best of everything in your Future!

      Ernie

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