Q: I am 25 years old and have a B.P. of 140/90 for the past 4 years. I do not have any symptoms to make me feel that I have a high blood pressure. I am an athlete and a good sportsman. One doctor said that I have to take medicines while another felt that there was no need for any medication at this stage. One of my friends told me it could be due to a problem in the urinary system. I am feeling perfectly healthy. Please suggest what I should do.

A:There are quite a few unanswered questions about your blood pressure (BP) which would need to be answered before a decision can be made whether you need to be treated for it or not. For example, you did not tell us whether one of your parents also has high BP; usually that is the commonest cause. A variety of kidney diseases can also cause a high BP and not all of them have any symptoms in the early stages. The high BP does not give any symptoms either, so your lack of any symptoms does not mean that nothing needs to be done. The first question that needs to be settled is the state of your BP over a 24-hour period. Presumably, it has been at 140/90 or higher for some time but you need to know whether it is high at other times or only when you have it checked by your doctor. This can be done by having an ambulatory monitor attached to you and your BP measured over a 24-hour period. If the BP is high at other times, then it needs attention and in the first place you can do simple things, such as reducing the alcohol (if you are enjoying a drink)and salt intake. If neither of your parents or grandparents has high BP then you need further investigations. For example, your kidney needs to be investigated, as sometimes the main blood vessel to the kidney is narrowed and causes BP to rise. In short, you need to have a thorough medical assessment in a hospital setting by a clinician who is interested in blood pressure. I hope that answers your query.