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How can I reduce my blood pressure and manage my worries?

Tuesday, 15 November 2005
Answered by: Dr. V. S. Ramchandra
Professor and Head, Department of Cardiology
Kasturba Medical College
Manipal
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Q. I am 36 years old. I am 5 feet 10 inches tall and I weigh 77 kg. I am suffering from hypertension. Two months ago my blood pressure (BP) was 120/176. I was admitted in ICU and relieved the next day with BP level of 120/80. I work for 9 hours in a multi task environment. Apart from that, I also have certain personal problems, which I can't describe. I think a lot about my future, career, children and finance. I have undergone tests for diabetes, lipid profile, TMT, Heart doppler and renal doppler test and all were negative. I am on Losartan 50 mg (1 tab daily), Epitril 0.5 mg (half tablet), only if I feel uneasy and Pantocid (daily morning/evening). My problem is that I feel tired when I am stressed and I get a slight chest pain, which initially used to remain overnight but now remains only for an hour or so. I regularly do yoga for half an hour in the morning, but I can't walk for more that 15 minutes. Beyond that I feel tired. I also had acidity and gastric problems. Please advise.

A.  You are self-admittedly stressed. You are already doing yoga. I hope it includes a good bit of pranayama which has both bhastrika (fast breathing) as well as regular pranayamic exercises with slow inhalation and exhalation (around 10 cycles/min) with concentration on the breath done in a proper erect sitting posture. It is proven that this type of breathing sensitises some receptors in your body to lower your BP. Also you will learn to stay detached from the worries of mundane life and enjoy life as a spectator rather than a participator. Try to reduce your salt intake too and if you can eat less rice and regularly take a morning walk to reduce your weight a couple of Kgs, it will help reduce your BP. The shortness of breath with minimal exertion as well as the tingling that you sometimes feel are common with stress. Your other tests are normal & that is very reassuring. As you are young and your BP was quite high on that day (although well controlled now) you might consult your doctor about three additional tests that are done to rule out some directly treatable causes of hypertension: 1) Serum Potassium & creatinine (you might have already had these tests) 2) Doppler of renal arteries to rule out renal artery stenosis 3) 24 hours urinarymetanephrines to rule out phaechromocytoma. If your doctor has not advised these tests he probably is convinced that your transient sudden BP increase was due to stress and you may choose to continue your treatment without these tests unless your BP shoots up again or there are changes in the blood tests (Creatinine or potassium). Your BP is well under control and your tests are normal. Things look good! A little confidence and effort from your side and every thing should be OK.

A.  You are self-admittedly stressed. You are already doing yoga. I hope it includes a good bit of pranayama which has both bhastrika (fast breathing) as well as regular pranayamic exercises with slow inhalation and exhalation (around 10 cycles/min) with concentration on the breath done in a proper erect sitting posture. It is proven that this type of breathing sensitises some receptors in your body to lower your BP. Also you will learn to stay detached from the worries of mundane life and enjoy life as a spectator rather than a participator. Try to reduce your salt intake too and if you can eat less rice and regularly take a morning walk to reduce your weight a couple of Kgs, it will help reduce your BP. The shortness of breath with minimal exertion as well as the tingling that you sometimes feel are common with stress. Your other tests are normal & that is very reassuring. As you are young and your BP was quite high on that day (although well controlled now) you might consult your doctor about three additional tests that are done to rule out some directly treatable causes of hypertension: 1) Serum Potassium & creatinine (you might have already had these tests) 2) Doppler of renal arteries to rule out renal artery stenosis 3) 24 hours urinarymetanephrines to rule out phaechromocytoma. If your doctor has not advised these tests he probably is convinced that your transient sudden BP increase was due to stress and you may choose to continue your treatment without these tests unless your BP shoots up again or there are changes in the blood tests (Creatinine or potassium). Your BP is well under control and your tests are normal. Things look good! A little confidence and effort from your side and every thing should be OK.

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