Q: I am a 37-years-old housewife with an 11-years-old son. I have high blood pressure for which I take Minipress XL-5mg (one per day) + Atpure 25 (half per day). Last month I carried some weight, like half a bucket of water and I felt a mild fleeting pain on the left side of the chest. The pain came after a few hours and lasted for a minute or two. What is the reason for this? Incidentally, after I lifted buckets of water down the stairs for a month, I was diagnosed for high blood pressure. I also had a very high rate of palpitation that time. I also have mild breathlessness for more than a year now. However, my family physician dismisses it as a normal symptom associated with BP patients. All my x-rays, blood tests and ECG are normal. I am keeping my BP under control with the help of medication and diet. Am I developing any cardiac problems? What tests should I undertake? My mother passed away when she was 40 years old due to heart attack. She was also a chronic BP patient and a diabetic too.

A:In view of your symptoms of breathlessness and discomfort on acute exertion, an evaluation to rule out associated heart disease needs to be done. A stress test (TMT) and an echocardiography is also advisable. The medication for BP control in your case also need to be reviewed in light of the recent data on better drug regimens for BP control. It has been shown that drugs like Amlodipine and ACE inhibitors provide better long term protection than the drugs you are on. This needs to be reviewed by your treating doctor. In addition, cholesterol lowering drug like Atorvastatin is recommended in most individuals with hypertension on drugs.