Q: I am 31 years old. I got my blood pressure checked and found that it was 150/90. I checked it about 4 times on four consecutive days in the morning and the readings are as follows: 148/94; 138/90; 150/92 & 126/86. I got it checked because I was feeling dizzy and tired all day for a long time. I work in a software company and tensions are enormous. The doctor has prescribed NEBICARD-5 once daily. Should I take the medicine at this age or are there any alternatives? I came to know that once I start taking the medicine I have to take it for life. I am still unmarried, will it affect my married life?

A:Unfortunately there is lot of overdiagnosis of hypertension. Therefore the following measures need to be taken before a person is diagnosed as suffering from high BP: 1. Two to three blood pressure readings per visit (sitting) on at least four occasions separated by 2-3 weeks. Only the lowest reading should be noted. 2. Only when the lower reading is more than 90 mmHg, does one need to proceed further. 3. In your case two of the four readings are within normal range. Also it is not clear if the above procedure was adopted. If not then fresh readings should be taken. 4. Even if the readings are above 90 mmHg (lower diastolic), then it is advisable to repeat the whole process by another doctor. There are lot of errors in taking blood pressure. One should never rely on electronic instruments since they have a large error margin. Also self measurements are not accurate in the beginning due to anxiety. 5. Even if finally the diagnosis of hypertension is made, non-drug measures must be tried for 6 months. Only when non-drug methods fail, then and only then should one use medicines. 6. Non-drug methods include reduction of weight if required, stop smoking if applicable, reduce salt intake, reduce dietary fat, increase exercise, learn to live with stress, reduce alcohol to no more than 10 units per week with at least two alcohol-free days (if applicable). 7. Even if drugs are needed after 6+ months, betablockers such as nebivolol (Nebicard) should be avoided in young, sexually active patients.