Hi,

Thanks for writing in.
I am a qualified cardiologist and read your mail with diligence.
I assume that you are taking the same drugs for almost 3 years but recently are having these symptoms. Firstly we will have to answer are these symptoms because of either of drug. Asomex AT is combination of S-Amlidopine and Atenolol. Amlidopine can cause pedal edema, rarely it may manifest later. Atenolol a betablocker crosses into brain. It can produce depression. Which may manifest as anxiety disorder. If you do not have any other obvious cause related to job or family to be under stress. Perhaps we can blame this component of drug. We can substitute this with other drug. Discuss with your doctor and get prescription for Telmisartan 40 mg once a day. If symptoms abate we can be sure that drug was responsible. Telmisartan does not have anxiety like side effects.
One thing more, I was reading about your family history this is right age when you should complete the list of risk factors for coronary artery heart disease profile.
LIST OF RISK FACTORS
At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension*
Smoking+/-
Stress*
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease* and diabetes*
Increasing age*
Being a Man (as opposed to women) till the age 45*

From the list, above you have some modifiable risk factors and almost all non modifiable risk factors. Therefore, in addition to hypertension and stress you have to complete the risk factor profile and bring it down. Diet, Drugs and Exercise will go long way to reduce your risk.

It is fair to assume that you are overweight because that is single most important contributor to hypertension. It is never too late to change. With your weight everything you do will have to be under supervision. It need not be cardiologist but your primary doctor can guide your way back to health - I am happy to read that. You may need drugs and he/she (or ask the dietitian) to advise you about diet low in calories and cholesterol, advise you on quantum of exercise. You ought to keep your weight under control for you do not want other attack. If you like non vegetarian you cannot take red meat but there is no bar (in taking certainly quantity had to be less) on egg white, roasted chicken and roasted fish.

If you have any further query please ask I shall be happy to reply asap.

With Best Wishes

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

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