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High Blood Pressure

High blood pressure in healthy 37 year old

05/29/2007

Question:

In January I went to the doctor very sick with blood pressure of 150/120. I was immediately put on medication and the pressure fell. At first we thought the birth control pill was the culprit, but I have been off for five months now and my pressure is consistently borderline 130/90, with fluctuations either way. It tends to be higher in the evenings or after I`ve been sitting at a desk all day. I am currently taking 25 mg Toprol XL daily. I`m a 37 year old female, 5`5" and weigh 122 lbs. I have always been active, but recently stepped up working out as I`m training for a triathlon. I try to keep sodium intake below 1200 mg daily. I`ve had the renal scan and urine test for pheochromocytoma. Everything is negative, even thryoid. I feel like I`m too young and too healthy to be having this issue, and I do not want to be on medication forever. Are we missing something?

Answer:

It appears that you are in good general shape.  You are not overweight (your BMI is 20.4), and you exercise regularly.  Unfortunately, even the best of lifestyles cannot always prevent hypertension.  About 50% of your risk for hypertension is genetic.  If your parents are hypertensive, your risk is greater.

25 mg of Toprol XL is a low dose.  Toprol XL is a beta blocker, and at higher doses it may reduce your maximal exercise capacity.  If you participate is competitive sports you may consider different classes of drugs, like angiotensin receptor blockers or ACE inhibitors.  These drugs are well tolerated and do not interfere with exercise capacity.  They are contraindicated in pregnancy, however.

If you are indeed hypertensive, you will likely need medication for the rest of your life.  On the bright side, remember that, given your young age, this can increase you life expectancy by an estimated 5 to 10 years.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati