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How To Treat Cardiac And Physical Problems?
A 5 6 , 210 lb., 64-year-old male business executive had a physical exam prior to his retirement from corporate work. His blood pressure was 180/115 on three separate days. Further examination showed normal to low plasma renin activity, elevated total peripheral resistance (TPR), cardiac output (CO) of 7.2 L/min, x-ray evidence of left ventricular hypertrophy , retinal hemorrhages, and mild polyuria . Recommended therapy was weight reduction to his ideal level, a low-salt diet ( 2 gm/day sodium), prudent exercise, and a reduction in alcohol consumption ( 3 oz whiskey/day). This change in lifestyle did little to change the condition. Medication was initiated in the form of an oral diuretic and progressed to a beta-blocker; eventually a vasodilator was included to reduce the blood pressure to 140/90.
Wed, 27 Jan 2016
Hello , I am Dr. Mody and I would be addressing your concern .
I went through the history in detail and I would like to say that the protocol followed be your doctors is in consensus with the standard one followed throughout the world .
I understand your frustration when lifestyle modification didn't bring the pressures back to normal .
Here I would like to point out that even with optimum diet and aerobic exercise tge maximum decrease in blood pressure achieved in all the studies have been a decrease was upto 7 mm He in systolic and 4 mm hg in diastolic pressure .
So when your blood pressure in the initial part was so high by joining means it was going to normalise without medication.
Lastly because of low renin activity , the most effective medication ace inhibitor / arb wouldn't have been the best choice for you .
The only change in my strategy would be a diuretic than proceeding to vasodilator and than lastly beta blocker , as it's not the most effective anti hypertensive .
All said and done , your treatment is perfect and do keep a follow up with your doctor.
Regards Dr Priyank Mody
I went through the history in detail and I would like to say that the protocol followed be your doctors is in consensus with the standard one followed throughout the world .
I understand your frustration when lifestyle modification didn't bring the pressures back to normal .
Here I would like to point out that even with optimum diet and aerobic exercise tge maximum decrease in blood pressure achieved in all the studies have been a decrease was upto 7 mm He in systolic and 4 mm hg in diastolic pressure .
So when your blood pressure in the initial part was so high by joining means it was going to normalise without medication.
Lastly because of low renin activity , the most effective medication ace inhibitor / arb wouldn't have been the best choice for you .
The only change in my strategy would be a diuretic than proceeding to vasodilator and than lastly beta blocker , as it's not the most effective anti hypertensive .
All said and done , your treatment is perfect and do keep a follow up with your doctor.
Regards Dr Priyank Mody
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