Been taking Lisinopril 25mg and some sort of beta blocker (previously metoprolol 25mg now propranolol 10mg 2x/day) for years and years. Exceeding exercises guidelines I believe for both resistance training and conditioning (lift 4x, peloton zone 2-3 30min 3-4x). High end of ‘normal’ BMI, 36.5" waist. Very good conditioning. Systolic 125-130 typically after multiple tests. Age 37, should I inquire about adding another pill to the box to get me in the 100-120 range? I’ve been medicated for hypertension since I was 25 years old.
Unless there is a specific reason for it, I would be asking to switch off of the beta blocker altogether, as neither metoprolol nor propranolol are good choices for high blood pressure; there are far better options. Additionally, given that you were diagnosed with hypertension at a young age, and are generally lean and healthy, I would also want to make sure there has been sufficient evaluation for underlying causes of/contributors to high blood pressure like primary hyperaldosteronism.
We discuss this topic in greater detail here: Blood Pressure - Causes, Prevention & Treatment
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Thank you, doctor. At a young age when I was first diagnosed, I saw a nephrologist and had an ultrasound on my kidneys I believe to check for that particular tumor. I do have PVCs (although my symptoms have eased significantly in the last year) so that is the purpose of the beta blockers (I don’t think they’re helping anyway, would be happy to discontinue). I have had echos and event monitors from several cardiologists and have no structural issues in my heart AFAIK.
I was obese as a child and teen, if that is medically relevant.
These additional details are why it is often difficult for us to provide individualized advice via the forum. I will say that an ultrasound is not sufficient to rule that diagnosis out, but a nephrologist would know this; I do not have the rest of your medical evaluation here to determine whether it was complete. Add in considerations of PVCs and whether they should be treated, and this becomes complex enough that an individualized conversation with a physician would be helpful to guide treatment decisions, including an individualized blood pressure goal.
Got it, thank you. Rest assured that I am regularly seeing physicians and following their advice and prescriptions. Appreciate the feedback and the second opinion. At my next checkup (next week) I’ll broach primary hyperaldosteronism. Cheers and thank you for your consideration.
Sure. And to clarify – that is not the only diagnosis that I would be thinking about in a young, lean/healthy person with hypertension requiring multiple medicines, but just an example of one that is often under-recognized and under-screened for, especially in primary care settings.