What Causes Slight Elevated LVH Despite Having Normal BP?

Posted on Tue, 9 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. I have attached my echo report and images, in report you can see LVH as 1.2 cm but in the images it show 1.27 cm. I have controlled my blood pressure since last week which is most of the time less than 125/75 at times it elevates to 135/85.
These are my BP readings.

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
1.00 pm 130/74
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

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
Need to work on weight .

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Your have slight LVH. See this LVH can't be reverted back but can be controlled so that it doesn't progress further.
Your BP readings are wonderfully controlled and so you should carry on with the combination of Telmisartan and Amlodipine.
The worrisome issue is your weight. Since you are over weight so obviously your heart is under stress.
You need to get into a perfect waist line so that to prevent further complications.
I am glad you have started working on it. Increase the dose of exercise gradually and still if you don't get the desired results then you can discuss with your doctor about starting you on Anti obesity Medicine Orlistat.
Also keep a watch on your lipid profile.
I hope it helps. If you have any further query, please ask me.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (24 minutes later)

Thank you Dr. at present I am under Olemesartan Medoxomil/Amlodipine Besilate (40/5 mg), is this enough? I stay in Saudi Arabia, so I am not sure about other medicines. Moreover my attending cardio said that the this LVH can be regressed back to normal within one year with the medication and diet. Secondly my brisk walking is 50 mins to 1 hour. I think I have lost good number kgs now (might be 5-7)as I did not weigh yet. And did you go through my Echo report and Images?

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
Carry on with that.

Detailed Answer:
Hi.
Yes I have gone through your reports.
I would recommend to carry on with the same treatment. I appreciate if you have lost 5-7 kg in a short time.
Start with cardio workup that includes running , cycling and brisk walking as you are doing.
You don't need any change of treatment. Carry on with that and just get your lipid profile under check.
I am today satisfied with your ongoing treatment and the measures you are taking. No other efforts are required.
I hope it helps you.
If you have any further query, please ask me.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar