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Suggest Treatment For Left Ventricular Hypertrophy And High BP

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Posted on Fri, 5 Jun 2015
Question: I am working in IT (under pressure) environment, hence I go every quarterly to cardiologist for regular checkup, it has been 10 years regular checkup at times I had high BP (150/90 -160/90), doctor never prescribed me medication during these years I underwent 4 time stress test (last one was three years before). Everything was normal, last two week I was feeling more stress and I went to doctor for checkup, he has asked for a ECHO test and told me that you have mild LVH (1.27cm) but this is not significant and your BP is 155/90 and we need to control it. At present he has prescribed me Olemesartan Medoxomil/Amlodipine Besilate (40/5 mg). At present I am working aboard and my friends asked me to go back to my country XXXXXXX I need your suggestion. (My age is 43). My present weight is 97 kg and I have started brisk walking since last week and also I am on diet. How shall it me to bring LVS (<1.0 cm) to normal.
doctor
Answered by Dr. Sukhvinder Singh (2 hours later)
Brief Answer:
control blood pressure and weight.

Detailed Answer:
Dear Sir
1. There are two things which are causing left ventricular hypertrophy or LVH. These are high blood pressure and higher than normal weight.
2. If you are an Asian, your ideal body mass index is 23. In case of non-asians it is 25. It is calculated as body weight in kilogram divided by square of your height in meters. Try to maintain optimal body mass index.
3. Whenever higher blood pressure readings accompany LVH, drug treatment should be started for high blood pressure. Beside avoid excessive salt intake, reduce weight, do supervised exercise, do not smoke or take alcohol, do meditation/ relaxing exercises. DASH diet can be started after discussing nutritionist.
Hope this helps.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (3 minutes later)
Dr.

Thank you for your reply... at present I started brisk walking for 45 mins? Is this affect LVH? and Is this possible to bring the LVH to less than 1.00 cm?
doctor
Answered by Dr. Sukhvinder Singh (6 minutes later)
Brief Answer:
yes. LVH can be decreased.

Detailed Answer:
Dear sir
1. Doing brisk walk definitely improves cardiovascular health and outcomes. However you may require some more exercise in order to reduce weight which will be best guided by a physical instructor.
2. LVH can be reversed by reducing weight and controlling BP. Some group of drugs like ACE inhibitors are well known to reverse LVH.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (9 minutes later)
Dr.

My attending cardio said you don't have any significance and you are not restricted from any physical activities. He said control the BP and he prescribed Olemesartan Medoxomil/Amlodipine Besilate (40/5 mg) which is really being effective in my case. Also my cardio said this is mild LVH and you should not bother. I had my BP tested this morning in the cardio clinic whic was 110/70 but at office this is fluctuating from 135-125/70-85. Is this okay? Once more thing I don't understand ACE inhibitors? Is this the antihypertensive medicine?
doctor
Answered by Dr. Sukhvinder Singh (11 minutes later)
Brief Answer:
please see details

Detailed Answer:
Dear Sir
1. Yes it is true that this much of LVH is classified as mild. However any degree of LVH should be treated aggressively but not by worrying.
2. ACEI is a group of medicines to reduce BP. However you are taking olmesartan which has similar overall effect. Main aim is to keep BP under the target of 140/90 mmHg, which your medicines are doing well.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (16 hours later)
Dr.

I hear from cardiologists that people who has LVH more than 1.50 cm has normal life for years. Is this true? Then I am so much worried more than me my spouse is upset and worried.
doctor
Answered by Dr. Sukhvinder Singh (2 hours later)
Brief Answer:
please see details

Detailed Answer:
Dear Sir
1. Hearsay is something which is not good in medicine. Try not to believe it. Still, since you have asked, I will explain the technical aspects.
2. The LVH has many causes including high BP, obesity, valve diseases. There is a variety of LVH which does not have a cause and is called HCM. The outcome not only depends upon degree of LVH but also on cause of LVH. In some cases of HCM the outcome is good despite hypertrophy greater than 15 mm. However in your case LVH is not only LVH but it also indicates uncontrolled underlying blood pressure and excessive weight. So out come will be determined by effects of high BP and obesity on whole body. It has been proved in trials that any degree of LVH associated with high BP is harmful.
3. However it is not something to be depressed and get overanxious. Just follow advise of your physician.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (3 hours later)
Dr.
Thank you very much for clean answer. My BP is within 115-130/70-75 with the hypertensive medication. Can I start the GM Diet, this is easier and knows to me?
doctor
Answered by Dr. Sukhvinder Singh (8 minutes later)
Brief Answer:
please see details.

Detailed Answer:
Dear Sir
1. You can start any weight reducing diet including GM diet after a consulttion with a dietician.
2. DASH diet is specifically meant for high blood pressure. It says Dietary approaches to stop hypertension.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sukhvinder Singh (21 hours later)
Dr.

It seems I have reduced my weight 5-7 kgs as it looks and I did not weigh yet. I brisk walk 50 min to 1 hour. The following are the BP values of today and yesterday.
Time      19-May-15      20-May-15
5.00 am     125/70      136/84
7.30 am     127/75      122/75
9.00 am     126/74      125/68
9.30 am           108/58
10.30 am     128/71      119/69
11.30 am           110/74
1.00 pm     130/74      124/73
2.00 pm     123/76     
3.00 pm     128/74     
5.00 pm     121/75     
5.30 pm     119/72     
7.00 pm     136/89     
8.00 am     121/80     
9.00 am     125/75     
10.00 am     116/74     
doctor
Answered by Dr. Sukhvinder Singh (2 hours later)
Brief Answer:
keep it up.

Detailed Answer:
Dear sir
1. All these readings are within limits. LVH do not develop in days rather it develops in months to years and will disappear slowly.
2. Keep it up. Take medicines regularly and maintain healthy life style. Visit your doctor regularly.
Sincerely
Sukhvinder
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sukhvinder Singh

Cardiologist

Practicing since :1998

Answered : 1306 Questions

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Suggest Treatment For Left Ventricular Hypertrophy And High BP

Brief Answer: control blood pressure and weight. Detailed Answer: Dear Sir 1. There are two things which are causing left ventricular hypertrophy or LVH. These are high blood pressure and higher than normal weight. 2. If you are an Asian, your ideal body mass index is 23. In case of non-asians it is 25. It is calculated as body weight in kilogram divided by square of your height in meters. Try to maintain optimal body mass index. 3. Whenever higher blood pressure readings accompany LVH, drug treatment should be started for high blood pressure. Beside avoid excessive salt intake, reduce weight, do supervised exercise, do not smoke or take alcohol, do meditation/ relaxing exercises. DASH diet can be started after discussing nutritionist. Hope this helps. Sincerely Sukhvinder