Brief Answer:
Episodic hypertension doesn't need treatment with antihypertensive drugs

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I understand your concern and would explain that these blood pressure changes are quite normal.

You should know that during anxiety,sympathetic nervous system is activated, leading to a high production of chatecholamines (adrenaline and noradrenaline) in the blood.

These substances induce the heart to beat faster and harder and cause peripheral vessel constriction, thus leading to increased blood pressure.

Episodes of high blood pressure induced by anxiety or even the doctor visit (also called "White coat syndrome", don't seem to increase the cardiovascular risk, based on different studies.

So they don't need to be treated, because they are considered benign conditions.

Regarding the changes in your eye vessels, accentuation may be related to the vessel narrowing (stage I retinopathy), but other causes should be investigated too (possible diabetes, etc).

I would recommend you to closely monitor your blood pressure during the day (in sitting position, after 15 minutes of total relax) and refer these values to your attending physician.

If your blood pressure values stay below 130/90mm Hg most of the time, there is no need for therapy.

I would also recommend performing a resting ECG, a chest x ray study and some blood lab tests:
-complete blood count
-PCR, sedimentation rate (inflammation)
-kidney and liver function tests
- fasting glucose
- blood electrolytes
- thyroid hormone levels ( to exclude possible thyroid gland dysfunction)
- cortisol and aldosteron plasma levels (to rule out possible adrenal gland dysfunction),

to investigate for other possible causes of secondary hypertension, which could also lead to your retinal changes.

Meanwhile, I would recommend you to make some lifestyle modifications to help you maintain your blood pressure under control:

-reduce salt and caffeine intake. A balanced diet would be ideal.
- perform a lot of physical activity (it is recommended 30 min walking per day, aerobics, etc.)
- lose weight, especially if you are overweight.

Besides, in case of frequent panic attacks and anxiety, I would also recommend consulting with an anxiety specialist to help you manage this situation.

Psychotherapy, Yoga and some anxiolytics may be necessary for this purpose.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri

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Brief Answer:
There is nothing to worry about.

Detailed Answer:
Hello again XXXX!

You should know that heart rate values up to 100 bpm are not considered abnormal or harmful. They are just a normal heart rate.

So there is nothing to worry about.

It is normal to have a higher heart rhythm when you get excited. They don't ned to be treated.

Only if you have palpitations or dizziness you can take low doses of betablockers.

Regarding your basal heart rate, it may be just physiological.

Anyway I would recommend performing the above mentioned tests ( complete blood count, thyroid hormone levels, cortisol and aldosteron plasma levels, blood electrolytes), to exclude any possible metabolic cause related to this heart rate.

Hope to have been helpful!

Best wishes,

Dr. Iliri

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