21 with high blood pressure

[wiggles]

So my blood pressure has been consistently high for about two years, ranging anywhere from 130/80 to 155/80. I'm 21, male, I weigh 166 lbs., don't smoke, don't drink excessive caffeine, my labs all came back normal (blood and urine). I'm not the most active person, but I don't sit around all day either.

The doctor recently put me on linsinopril. She said it is likely a genetic issue and I will require medication for the rest of my life. From what I've read this drug has been well studied, but I still feel uncomfortable being on blood pressure medication at 21.

She said its best to start it now before real problems develop.
Are there any other options to lower my blood pressure? Anyone else with a similar experience?

 

[dokomo]

First of all, I'm sorry that you're having trouble with your blood pressure! However, it is SO good that its been diagnosed this early in the game. There is a lot that you can do (both with medicine and lifestyle) to keep it in check and prevent all the damage that it can cause.

First of all, I totally understand not wanting to take medication. I'm 24 years old, and I don't like the idea of taking a pill every day (although for a particular condition that I have, I do.) The thing with hypertension, though, is that it is a silent killer. You don't realize the damage that it is doing 24 hours a day to your blood vessels, organs (the kidneys and heart, especially) and other body systems. Hypertension is also a major risk factor for erectile dysfunction, making it much more likely for this to occur. If you let this go untreated, you could realistically be facing heart attack and kidney disease by the time you're 30 years old. In light of these facts, taking medication is a MUST.

A couple of notes on lisinopril (your doctor likely already mentioned these, but just in case)

- Don't take it with aspirin/ibuprofen or medications that contain them (they reduce the effectiveness of lisinopril.) Use acetaminophen instead for pain/fever/headache.

- Don't take lisinopril within two hours of antacids (these also reduce its effectiveness.)

- Don't take lisinopril with potassium supplements as this can lead to retention and dangerous buildup of potassium in the body.​

Now, the lifestyle changes to make WITH medication:

- Aerobic exercise- You need to be doing this for at least 30 minutes a day, 5 days a week. This is probably the most powerful thing you can do to lower your blood pressure in terms of lifestyle changes.

- Dietary Changes- Keep your sodium intake below 2400mg/day. This is a pain, I know, but you need to start checking food labels and keeping track of this to keep it in check. Also, follow what is referred to as the DASH (Dietary Approaches to Stop Hypertension) eating plan.

- Alcohol- Keep alcohol consumption under two drinks per day.​

Follow these pieces of advice, and you should be able to keep your blood pressure in check and prevent many of the complications of hypertension. Keeping seeing your doctor and have your blood pressure checked often!! There are several other medication options if lisinopril doesn't work well for you.

Good luck man!

 

[Mehm]

You can probably control this with a lifestyle change. If you want me to go into detail please post back with your typical diet, stress level, and physical activity.

peace

 

[wiggles]

My diet is pretty good for being a college student. On a typical day I usually eat something fast and easy for breakfast, a bagel or power bar. At Lunch I usually have turkey sandwich or something similar. Dinner is usually salad and pasta. I also love vegetables and fruit.

I get a fair amount of exercise also. I walk everywhere as I don't have a car. I also try to get to the student rec building to play basketball, soccer, etc. whenever I can.

I have been stressed over the past few years but lately this hasn't been an issue which is odd because lately my blood pressure has been its highest. The only real contributing factor I see is alcohol consumption, but I only go out drinking two nights a week and have been trying to cut back on the number of drinks.

 

[Mehm]

I doesn't look like you have any glaringly obvious risk factors. Here is some food for thought.

-Salt is a big contributor to HBP. Even the daily recommended intake is considered high for people dealing with this issue. Sauces and meat are usually infused with a lot of salt. As is packaged food.

-Try some relaxing exercise like hatha yoga, quigong, or tai chi. Maybe your school has classes on meditation? All these activities have been shown to reduce blood pressure.

-As you know, alcohol increases blood pressure. It sounds like you are extra prone to its negative effects.


Now, you can make a choice. Just do what you are doing and stay on the pills. This isn't the end of the world and I understand that being on these pills for life is pretty safe. Or, really radically change your life and get off the pills. IMO this would probably require a mostly raw, vegan diet that is very low in sodium, no alcohol, and embracing the meditative arts. Some sort of compromise between the two worlds could probably be found where in you change some parts of your life and go on a lower dose of the medicine.

Good luck man! I have a kidney disease that makes me prone to HBP as well. That's why all of this stuff is on the front of my mind.

 

[dokomo]

^Lifestyle changes are almost never sufficient when a young, healthy, not overweight person has hypertension. There are immutable genetic factors at play that no amount of healthy dieting alone could fully address, which is why his doctor prescribed medication. A combination of the medication and diet/exercise are almost surely going to be needed to effect change.

 

[Mehm]

Sorry, I don't believe that.

 

[Cane2theLeft]

^do you have ANY evidence to support your incredulity or is just blind faith in your yoga regimen?

I really don't mean to come off hostile but in this instance, someone ignoring scientifically-backed medical advice could have profoundly negative effects.

 

[Mehm]

There are immutable genetic factors at play that no amount of healthy dieting alone could fully address, which is why his doctor prescribed medication.

Each gene has thousands of different possible expressions depending on environmental stimuli. The amount of diseases linked to a single gene is very small. I'm not sure if this particular type of HBP is one of those disease. Does anyone else in the thread know?

do you have ANY evidence to support your incredulity or is just blind faith in your yoga regimen?

I really don't mean to come off hostile but in this instance, someone ignoring scientifically-backed medical advice could have profoundly negative effects.

Besides the mountains of anecdotal evidence from all over the world, here are two studies off of the first page of google scholar that point towards a non pharmaceutical answer.

I didn't tell the guy to stop taking medicine. All I said is that lifestyle changes could help him not be on pharmies for the rest of his life. Also, accusing someone of incredulity and blind faith is pretty hostile.

Systolic blood pressure and long-term practice of the Transcendental Meditation and TM-Sidhi program: effects of TM on systolic blood pressure

RK Wallace, J Silver, PJ Mills, MC Dillbeck and DE Wagoner

Systolic blood pressure was measured in 112 subjects practicing the Transcendental Meditation (TM) and TM-Sidhi programs. The subjects were between the ages of 35 and 64 years. A significant difference was found between the systolic blood pressures of subjects (matched for sex, race, and general educational background) practicing the TM and TM-Sidhi programs and norms for the general population. This difference was independent of diet and exercise patterns but related to length of time meditating. A significant difference was also found between short-term (under 5 years) and long-term (over 5 years) participants of the TM program, covarying for age. No previous reports exist concerning the long-term effects of the TM program on blood pressure. Despite methodological problems associated with cross sectional data, the findings suggest the beneficial effects of the long-term practice of the TM and TM-Sidhi programs on systolic blood pressure. Even if self-selection plays a role, the characteristics of an easily identifiable group already showing traits beneficial to the general population deserves further study.

Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials

Dickinson, Heather Oa; Mason, James Ma,b; Nicolson, Donald Ja,c; Campbell, Fionaa; Beyer, Fiona Ra; Cook, Julia Va; Williams, Bryand; Ford, Gary Ae


Purpose: To quantify effectiveness of lifestyle interventions for hypertension.

Data sources: Electronic bibliographic databases from 1998 onwards, existing guidelines, systematic reviews.

Study selection and data abstraction: We included randomized, controlled trials with at least 8 weeks' follow-up, comparing lifestyle with control interventions, enrolling adults with blood pressure at least 140/85 mmHg. Primary outcome measures were systolic and diastolic blood pressure. Two independent reviewers selected trials and abstracted data; differences were resolved by discussion.

Results: We categorized trials by type of intervention and used random effects meta-analysis to combine mean differences between endpoint blood pressure in treatment and control groups in 105 trials randomizing 6805 participants. Robust statistically significant effects were found for improved diet, aerobic exercise, alcohol and sodium restriction, and fish oil supplements: mean reductions in systolic blood pressure of 5.0 mmHg [95% confidence interval (CI): 3.1-7.0], 4.6 mmHg (95% CI: 2.0-7.1), 3.8 mmHg (95% CI: 1.4-6.1), 3.6 mmHg (95% CI: 2.5-4.6) and 2.3 mmHg (95% CI: 0.2-4.3), respectively, with corresponding reductions in diastolic blood pressure. Relaxation significantly reduced blood pressure only when compared with non-intervention controls. We found no robust evidence of any important effect on blood pressure of potassium, magnesium or calcium supplements.

Conclusions: Patients with elevated blood pressure should follow a weight-reducing diet, take regular exercise, and restrict alcohol and salt intake. Available evidence does not support relaxation therapies, calcium, magnesium or potassium supplements to reduce blood pressure.

 

[caseface99]

I need to show my girlfriend this thread. She has high blood pressure, similar numbers as the OP. She's 20, not overweight(like 5'4" 118lbs), and has know she has high blood pressure for at least a year or two.
But she doesn't really take it seriously at all. Only medication that she takes that might help is clonidine at night for sleep but I'm not sure how effective that is for hypertension, and she has a pretty shitty diet and no exercise. Not to mention she used to abused the fuck out of amphetamines and speedy E pills. I'm guessing i should be concerned? (not to mention SHE should be concerned..)

 

[Cane2theLeft]

I didn't tell the guy to stop taking medicine. All I said is that lifestyle changes could help him not be on pharmies for the rest of his life. Also, accusing someone of incredulity and blind faith is pretty hostile.

Incredulity means you don't believe something and you said "I don't believe that" so I don't think you should take that aspect hostilely. Regarding the faith comment, you have a point and I apologize. The way I viewed your advice was that you were suggesting something that's potentially harmful and that upset me... its not an excuse though for being hostile and I genuinely do apologize.

However, saying you only said 'lifestyle changes could help him not be on pharmies for the rest of his life' isn't exactly true...

You can probably control this with a lifestyle change.

...there you rather unequivocally said he could probably control it without medicine.

Now, you can make a choice. Just do what you are doing and stay on the pills. This isn't the end of the world and I understand that being on these pills for life is pretty safe. Or, really radically change your life and get off the pills. IMO this would probably require a mostly raw, vegan diet that is very low in sodium, no alcohol, and embracing the meditative arts. Some sort of compromise between the two worlds could probably be found where in you change some parts of your life and go on a lower dose of the medicine.

...There you told him he could radically change his diet and lifestyle and get off the pills.

Sorry, I don't believe that.

...There you said that you did not believe dokomo when he said, "Lifestyle changes are almost never sufficient when a young, healthy, not overweight person has hypertension."

______________________________

No one is denying that lifestyle and dietary changes will be beneficial and likely even necessary for the OP to control this issue. Dokomo and I are saying that given his age, they might not be sufficient alone to control it.

From the first study you cited...

The subjects were between the ages of 35 and 64 years

The second study just demonstrated that those lifestyle interventions showed BENEFIT in reducing hypertension. It in absolutely no way demonstrates that lifestyle changes will be sufficient alone for any 21 year old experiencing this let alone the OP specifically.

I asked if you had evidence to back up you not believing someone his age might have to be taking medication to control it and what you cited was not at all evidence of that.

I fully understand your perspective of trying to use natural lifestyle and dietary changes to address health problems but there are many examples where this is demonstrably insufficient and to suggest otherwise can be detrimental.

 

[dokomo]

Besides the mountains of anecdotal evidence from all over the world, here are two studies off of the first page of google scholar that point towards a non pharmaceutical answer.

Did you even bother to read these studies or just skim the abstracts and quote them here? The participant groups and concomitant risk factors (age, weight, diet, etc) are completely irrelevant to the OP's situation.

Back in the world of relevant science, regular exercise lowers systolic blood pressure by 5-10mmHg. Following the healthy (and as a bonus, medically valid) DASH diet reduced blood pressure by 8-14 mmHg.

So, even if both his exercise and diet were perfect AND both reduced his blood pressure on the maximum end of possibility, it would leave him with a blood pressure of 131/80 which is STILL medically pre-hypertensive and damage is still occurring. Someone his age and weight ought to have a systolic pressure of below 120 mmHg and a diastolic pressure at or below 70 mmHg.

Can you acknowledge, now, that medication is needed in cases like this? The vascular system only decreases in its efficiency over time, and the obvious genetic factors in play here will underscore these decreases in efficiency. He's already had elevated blood pressure for at least two years, which makes it that much more critical to lower it as much as possible to delay and prevent additional damage from occurring.

Your advice is good for about 95% of the people out there who are unhealthy, obese, and have awful diets. You must realize, however, that for some people (like healthy, 21 year old males with few environmental risk factors) it simply will not work alone and the alternatives are a shortened life span or supplementation with safe and effective medications. This doesn't invalidate your personal way of life or approaches to managing your own health, its just a medical fact.

 

[Mehm]

To clarify, I don't think OP should suddenly embrace the lifestyle I laid out and stop the pills. If anything it should be a slow process.

On the studies I posted. They point to a lifestyle solution. The many books written on the subject surely make a more conclusive case.

Radical changes in diet alone have cured end stage cancers and a host of other "incurable" disorders. The living evidence is people walking around and telling their stories every day.

Living on the medicine is certainly a viable option. I would agree that it is definitely the best option for a person who wants to keep living his normal life while making a few changes like eating less salt or having less drinks. It is what my family does in response to our genetic kidney disorder (it raises blood pressure).

I still stand by the possibility that almost any medical condition can be completely remedied with radical lifestyle changes. Unfortunately, the empirical evidence at this point is thousands of years of anecdotes and a scattering of studies. The research money isn't there for big, controlled group studies (no one stands to profit from such research). However, the deductive evidence is mounting, specifically in the fields of Epigenetics, Psycho-Neuro-Immunology, and Health Psychology.

 

[Cane2theLeft]

^You could be right about this but the problem is that without studies, its unverifiable.

I know that personally if I convinced someone with a serious medical condition to eschew standard treatment protocol and then they DIED or it otherwise negatively impacted their quality of life or longevity, I couldn't live with myself.

I'm not convinced the books would make a more conclusive case... books have far less rigid oversight than peer-reviewed journals and anyone from any perspective can make unverified claims and use anecdotal examples of people "walking around telling their stories". Its not conclusive proof this is the best medical advice a person can get.

I respect that you have your own perspective but when you claim to know better than the entire medical community is where I start to take issue because that can be dangerous. I know without a doubt that you mean well, but it can still have very negative impacts on a real person here.

As dokomo pointed out, your suggestion can literally shorten his life because demonstrably those treatments are LIKELY insufficient to fully address this hypertension.

 

[socko]

I wonder if getting nervous at the doctor's office could give a misleadingly high reading? It happened to me once when they took my blood pressure at a dentist's office.

 

[Mehm]

I hope I've made clear to the OP and anyone else reading this thread that suddenly stopping the drugs is a bad idea. Is it wrong to suggest that a person makes lifestyle changes while experimenting with lowering the dosage, always keeping an eye on blood pressure? If the person were successful and monitored their BP every day, I don't see the harm in this. I could definitely be wrong though.

Any good book will be full of references to studies. Agreed?

I'm parroting the view of a subset of the medical community (naturo-paths, herbalists, energy healers, etc.) who stands against the "pharmaceutical first" practice that is the most common. The medical community is (albeit unevenly) divided on the issue.

If BP is under control through lifestyle changes, how is going off of medication shortening someone's life? All I did was suggest that this is possible. To say otherwise is dangerous IMO. The opinion of the ONE doctor that OP met with is hardly conclusive.

 

[socko]

^I would definitely do everything I can as far as changing my lifestyle to lower my blood pressure before I agreed to go on some pharmaceutical every day for the rest of my life. Not only that, but I would get a second opinion. And then, only if all else fails would I take the medication.

 

[wiggles]

Well I didn't mean to start a debate on the issue but I appreciate the replies. I did seek a second opinion from my family physician (haven't seen him since I left for school) and he also agreed I should be on medication.

So I'm just going to take the pills, try to make whatever lifestyle changes are applicable (like I said I'm already pretty healthy) and hope my BP is manageable from here on out. Again thanks for the input.

 

[Mehm]

Well I didn't mean to start a debate

lol, I think those of us participating enjoy this kind of thing

I'm glad you have found some personal answers

 

[cheap L]

good luck! you sound pretty motivated, so good to see.

Alcohol down, exercise up, smoking down = roughly 2 mmHg down on systolic
Salt is the biggest change = 5mmHg systolic.

give that a real good go (most Dr's should try 3 months of lifestyle change before meds). and you could get a home BP hired from the chemist for a bit to see if it isn't white coat hypertension.

if meds don't work in the first 6ms of trial, then look at 2ndary causes of high BP. but this is only 5% of the population and it's usually just essential HT, no known cause.that's what they teach in med school

if you can avoid all the hell of High BP end organ damage, you will thank your little tablets one day.