Further investigations yet?

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I 'm 66 and have had Type 2 diabetes for about 2 years, and hypertension for about 6, also raised cholesterol. My untreated BP was around 180-200/110-120 - so not good! Back in 2007 I was getting quite a bit of chest pain and was investigated, but with treatment my BP fell to around 115-130/65-80 and I had no problems. (At this time I was not diagnosed with diabetes. I have had a mild cardiac murmur since childhood, but this is considered insignificant.

There is a strong history of hypertension - both parents had it severely, several aunts and cousins were hypertensive and died of heart problems. My father had several heart attacks from age 60 and died of left ventricular failure. My mother had congestive cardiac failure.

Investigations in 2007

ECG

Treadmill stress test

Radio-isotope stress test - very slight narrowing of LAD, but considered

insignificant

Echocardiogram - mild left ventricular hypertrophy, presumably from BP

Over the past couple of years my BP has been rising, with my diastolic consistently above 85, and I was surprised that my GP only made one change to my medication. This last couple of weeks the chest pain on exertion or stress has returned, sometimes radiating to my neck. Yesterday my BP was 145/95 and I asked if I could add propranolol - also for my essential tremor.

I should like my BP to be below 130/80 as I have diabetes and a the above family history of heart disease.

My cholesterol is slightly raised at around 5.5. I had to come off simvastatin because of muscle pain, and was changed to bezofibrate 400mg daily. I've not had a cholesterol reading since then.

My blood glucose and HbA1c have been good.

Current main medication:

Adizem XL 120mg daily (diltiazem)

Lisinopril 20mg daily

Propranolol 40mg twice daily (added yesterday)

Bezafibrate 400mg daily

Metformin 500mg twice daily

Isosorbide mononitrate 10mg daily, increasing to twice daily (from 5 days)

GTN spray as required

My GP was unsure whether to refer me again today, but we agreed to see how things go with the added medication and review in a month, or earlier if there is no improvement.

Does this seem reasonable?

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5 Replies

  • Posted

    Well you have been through the mill you poor thing.

    It does annoy me when the docs ask us what we think about being reffered about conditions. That is their job after all!

    You cholesterol at 5.5 isn't that bad really. I've taken a statin for about 8 years and so far I've only managed to get down to 6.2. I do have the inherited kind though, so my body keeps trying to make more despite my very careful diet and the statin.

    Sadly you have like me and lots of others a bad genetic history of heart disease. This makes it harder for some of us to respond to the medication as easily as people who haven't.

    One of the big things is to try and not to get too stressed about numbers and the whole damn thing. This just makes the blood pressure rise even higher.

    I have heart problems too, in the electrical department and have had a murmur since birth and also have a gtn spray for occasional use. My dad's family all popped off before they reach 60, which I have just made and have every intention of getting futher.

    However my mother's dad also had the murmur and had to take Digitalis for his heart from age 40, in the days before statins etc; He also had diabetes and lived to the great age of 87. So I'm hoping that I take after him!

    I have learned over the years to slow down a bit and not to worry so much about what may not happen. This has helped my bp to drop a bit. My hubby also has bp problems and he gets in a right old tizz sometimes about it all. He's 63. We both also have underactive thyroids, mine for over 30 years.

    To be honest I think your doc is being resonable wanting to give you a couple of weeks on the Propanolol before going back to the consultant, to see how it goes. It did give me nightmares so I had to discontinue it so if you get bad dreams go back and tell him.

    My bp has never been below 130/80. I'd be thrilled if it was. Mine hovers about 140/90 and as it used to be around 200/100+ I think I'm doing ok. My Hubby's much the same.

    On another note, I have good friend who's mum lived to 98, with terrible high blood pressure for at least 50 years that my friend knew about, she absolutely refused to take any bp meds and ignored it... I think of her often.

    If you are really unhappy about not being referred to the consultant before the month is out then go along and tell the doc. Despite how we all feel about 'being a nuisance' that's what he's there for and it doesn't matter to him who's next through that door.

    Good luck and hope you feel better soon. Fanny Jane.

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  • Posted

    It was our joint decision not to refer. I have a great relationship with a super GP.
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  • Posted

    Apologies if I misunderstood your post. Only trying to help.

    It's really good that you have a great GP as not everyone has.

    Hope all goes well with your continuing treatment and you feel better soon.

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  • Posted

    I'm so lucky - there are at least two brilliant GPs at our surgery and we discuss everything - especially medication for this and my depression, and Dr H trusts me to let her know right away if I have problems. It's great to have this relationship - and also a great one with my vet (for my 24 rats!)
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  • Posted

    Wow 24 rats, not sure what to say about that!

    It's good to have proper medical care and a good relationship with your gp.

    It's bad enough being poorly and putting up with a body that won't do what you want it to and having pain as well.

    Hope the Propanolol has kicked in and helping. Best Wishes Fann Jane.

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