Brief Answer:
Start medication and lifestyle changes

Detailed Answer:
hi, I am Dr. Mody and I will be addressing your concern.
Some information I would be happy to know.
1)are you obese, do you smoke, are you diabetic, had any heart issue previously family history of heart problem?
Now life style modifications and diet can decrease your blood pressure maximum by 5 mm hg so here you would need to Start some medicine.
Now my strategy for you would be.
To start you on a anti hypertensive medication and with time and lifestyle when blood pressure is well controlled decrease the dose and try tapering of the medication Later.
So
1) cut salt in diet least than 3 gm / day. So no fried food, cut on oils and no food with preservatives. You may allow normal salt which is used in cooking, but no sprinkling of additional salt for taste.
2) aerobic exercise like brisk walking, cycling, swimming for 45 mins a day for atleast 5 days a week
3) To stop ayurveda medication and I wouldn't be able to titrate the dose of the drug when you simultaneously take that medicine
To start tab olmesartan 20mg with chlorthalidone 6.25 mg combination once a day, any standard brand available would be ok. You can take the medicine preferably in morning at fixed time everything, no need to take it at empty stomach
Sir if you are starting the meds I would like to know the pressure after 2 - 3 days. Or else do involve your Gp for monitoring, as we may be able to decrease the dose soon. Also during the first week after taking medication in sitting position and avoid sudden change in position for next 30 mins as when the pressure are brought down to normal you may have some dizziness as your body is used to higher pressure for so long. Also repeat serum creat and serum electrolytes after a week.
Now before you start some investigation are. Get an ecg for the chest pain, some basic blood tests like s. Creat, s electrolytes, should be done.
Any further clarification I would be happy to help.
Regards Dr Priyank Mody , XXXXXXX

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Brief Answer:
Ecg is normal, wait 4 medicine to work & get 2d echo,TMT if pain persists

Detailed Answer:
Dear XXXXXXX ,
good to know that you don't have any major risk factors for heart related problems .ie , your cholesterol , weight all is within acceptable range.
The ecg you have uploaded is within normal limits

We will have to give some time for the medication to act , so check the pressures after 2-3 days .
Now the pain you feel does than increase while you have to walk , or climb stairs, or while you are exercising . if no than we can wait for the pressure to come to normal and it should subside .
Also i would like if you can get a 2D echo and treadmill stress test at your convenience to rule out any underlying heart condition .
Regards Dr Priyank Mody
I would be happy to help if any furthur clarifications are needed .
If none you may close the discussion and rate it .
Have a good day

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