Essential Hypertension - is it a cause of concern?

[recyclealex]

Hi community,

I am not a medical professional and I'm just here to look for a second opinion and any suggestions on what I can do, or what are the actions that I should take to reduce the probability that my Essential Hypertension causes any health issues in the future.

Here is what I would like to know:
1. What is the "healthy" or acceptable blood pressure range that I should be getting (mid-day) given my considerations and circumstances mentioned below?
2. Should I be taking Beta Blockers rather than Calcium Channel Blockers? Are there also other considerations or alternatives that may be effective to my given situation?
3. Should my family's health history be of a large concern, or most likely it's due to my lifestyle choices?
4. I also have High Cholesterol, but i'm really not sure about the cause of it - is it likely linked to my other diagnosis?

Here are some facts about me:
- Male, Asian
- 25 years old in 2021
- 173cm
- 88kg (2021); 83kg (2019); 85kg (2020) - likely due to the Seratonin I started taking from mid 2020 for anxiety (due to work stress).
- Has Essential Hypertension & High Cholesterol
- Don't smoke
- Rarely drinks alcohol (1 time a month/quarter)
- Walks 7,000-10,000 steps per day
- Low intake of simple carbohydrates, replaced with complex carbohydrates
- Love to eat red and white meat
- Only vegetables I eat are usually Brocolli and green leafy vegetables
- Takes fruits sometimes
- Rarely drinks sugar drinks or fruit juice concentrate
- 3 meals a day, rarely snacks
- daily Coffee drinker (1 cup a day - black)

Here is my family's background:
- My paternal side of the family always had have high blood pressure (Both of father's parents had hypertension & paternal grandfather died of a heart attack at age 54)
- My father has 2 brothers, the older brother died at age 50 of a heart attack (he had hypertension)
- My dad started taking hypertension medication since the age of 19 (I'm not sure if he started on beta blockers or calcium channel blockers)
- My maternal side and my mum do not have any hypertension history.

Here is my history with essential hypertension:
- At 18-20 years old, I started to take notice that my blood pressure was 129/85 on average (mid-day) during regular health checkups, and sometimes reached 130/85 (mid-day)
- At 21 years old, I started to become an entrepreneur and since then had led to a high stress daily environment.
- I still get at least 7 hours of rest every day
- At 22 years old, I decided to go to a cardiologist to get diagnosed (in late 2019) as I noticed that my blood pressure when measured occasionally is 135/85 (mid day) to 138/85 (mid day) (until today - with Calcium Channel Blockers)
- It took me around 7 months to get a diagnosed with mild hypertension (ECG scans were normal and the other checks were normal)
- Since late 2019, have started taking Calcium Channel Blockers every day.

Notes on Prescription History for Hypertension:
- 2020: The specialist started to prescribed me with Pregabalin & Amlodipine (2.5mg) per day - was not effective in reducing blood pressure - 135/85 (mid day) to 140/90 (mid day).
- 2020: Amlodipine (5mg) per day - was not effective - 135/85 (mid day) to 140/90 (mid day).
- 2020-2021: Amlodipine (7.5mg) per day - was not effective 135/85 (mid day) to 140/90 (mid day).
- 2021 - now: NiFEdipine (30mg) per day

Investigative Lab Results (chronological order):
https://www.evernote.com/shard/s365/sh/11f84d18-3e59-46ab-84f4-adef1e11532b/25f86f48996249763b2999140a70a7d2

https://www.evernote.com/shard/s365/sh/9f0c6f12-f209-42ff-ae06-70e4efdac558/7c3b820eead33095e2b879725f957857

https://www.evernote.com/shard/s365/sh/980b1209-bbf9-41c2-b08b-59b998346770/bc73bfa32771a887e6a21ffb7930ac0c

https://www.evernote.com/shard/s365/sh/6391e718-b268-4c24-8ebc-81f1fab5fed0/b005ca76235f94f1b8d26d37e4906607

https://www.evernote.com/shard/s365/sh/f024b584-1f95-4087-9f66-be15781a7157/d64da70eea13c02327934dd3f1720f24

https://www.evernote.com/shard/s365/sh/9544f886-6d5d-4229-8076-b6e380f00272/6c8a43640e4c72b5318257c8b5457136

https://www.evernote.com/shard/s365/sh/ca41f58e-08bf-424b-9837-6348ddbd523f/3f3f9ed9683fe91cba64e05fc0a45476

https://www.evernote.com/shard/s365/sh/4376981b-561e-46ca-89e9-e980d5fedd4f/45a0fca541f4e98820e26e2e57000ee4

https://www.evernote.com/shard/s365/sh/616dfcd4-7a7b-460e-bff3-a8ead42449c8/01efdbf6d01f872f7ab44c43bc7ca5fd

https://www.evernote.com/shard/s365/sh/47b4be11-9c67-4a17-9237-c087684ba55d/d0f0b02e7e6072bad88fc0d7cff1f036

Prescription History (chronological order):
https://www.evernote.com/shard/s365/sh/9a717b56-140a-469b-a973-c0776311162f/6f9fe55e25f80cc41ab5967c92d6d1ae

https://www.evernote.com/shard/s365/sh/a867e009-1fff-44c0-83ba-9e668968b448/ad98f79531143fdfb8636e508da127d8

https://www.evernote.com/shard/s365/sh/a638f917-43b0-44d4-9a14-ee8464652cf6/476e8feae8e937a9057af0b3d01b306c

https://www.evernote.com/shard/s365/sh/6363aa69-f935-43c6-bf3a-6b1fdb672870/a85620aefb3e0548630accebceedfa76

https://www.evernote.com/shard/s365/sh/be0ec3c5-27e2-44a5-9e9e-cdf85bc50723/d01c30257d668c8d2650d5c8b1d1437d

https://www.evernote.com/shard/s365/sh/f0eb5877-425c-4932-9f75-3e6ba59c4d7b/a8708e1148aebfa1b641734de99dfbf1

Notes:
- All specialists/GPs that have prescribed me the medication above have mentioned that I am too "young" and as such, they refrain from providing me other types of medication for Hypertension until today
- I am taking Simvastatin as I have High Cholesterol, and since taking 10mg, it's under control since, and I'm still taking it everyday till today.

[specialmom]

I can relate to this problem.  I had pregnancy hypertension and it was a wake up call. They made it clear that I'd likely always battle hypertension in my life time and sure enough. . . I have familial hypertension. Your family history would indicate that you are as well. This makes things like your age and lifestyle important but less so.  You are likely genetically predestined for a bit more work on this end at your age than others. I would say that a second opinion with an actual doctor that can examine you would be important.  What you are indicating is that medications tried are not giving you the range of blood pressure that is best?  You are falling into the more borderline area (as I naturally did at an earlier age too). You seem to be of proper weight and you are exercising. I'd perhaps exercise a bit more (clear with doctor). If your steps are just that of your daily life (which does count but isn't always true cardio where you are exercising your heart).  It does look like perhaps some of your dietary choices could change such as maybe less red meat?  The DASH diet is proven to be helpful for hypertension.  Mediterranean diet is similar to DASH.  Maybe instead of three square meals, eat 5 smaller meals? But overall, I know it is concerning to have blood pressure issues and at a young age. It legitimately makes us worried about the future. But as you know, since you take medication for anxiety, worry in itself can have a negative impact. You are doing all that you can and care about your health. So, take peace in that.  I think a second opinion in your locale makes sense if you are not satisfied with answers your current doctor is giving "too young" as a way to blow off your concerns.  

[recyclealex]

Thanks @speciamom for the suggestions.

The medications that I am taking are Calcium Channel Blockers, which in some ways work to lower the blood pressure, but are "less direct" in terms of it's intended effects of lowering blood pressure. As a result, ever since I have been taking two different CCBs, my blood pressure is still within the range of 138/85 to 145/90 (with medication).

I was wondering if by switching over to Beta-Blockers (which I am aware that there are some additional downsides/side effects as compared to CCBs, which is probably why the specialists that I've seen are wary of prescribing that first).

I was hoping to get some insight on the differences between these two types of medication and suggestions based on my situation and history

[specialmom]

Hey, sorry!  I didn't circle back and am just now seeing this.  What is the current status? Did you switch to a beta blocker?

[Paxiled]

You're pretty young and therefore lifestyle changes can make a big difference for you.  Your blood pressure isn't actually all that high, so it should be able to be controlled through lifestyle changes -- not saying it will be, but it could be.  We're not medical experts here, so we can't really give you medication advice, so if you think beta blockers would be better for you your docs are the ones to discuss this with.  But again, you say you have high cholesterol, but you also say you don't eat a lot of veggies and do eat a lot of meat.  So there's something you can change right away by eating more fish, which is high in omega 3 fatty acids which can lower your bad cholesterol.  You don't say how you're cooking this food or if you're eating out a lot, but if you're frying a lot in poor quality oils, that's also something you can fix quickly.  Counting steps at your age seems odd to me, as you are able to exercise much more vigorously, and we know that while walking is helpful more vigorous cardio is much better at building the heart muscle and opening the blood vessels as long as you start slowly and build up to a safe level, with your doctor's permission.  Walking is for us old folks.  It's also not clear at all in any particular case that stress causes these kinds of problems -- can happen, can also not happen.  Depends on the person and genetics and lots of other things.  Stress is also a very individual thing, as it's something we often create with our thinking but which isn't an objective reality.  Life is always hard, but different people experience it very differently, and what stresses one person out is the cat's meow for someone else.  If what you're doing is causing you undue stress, it's possible it's not your thing.  It's also possible you have some level of an anxiety problem, and relaxation exercised and practices can help with this.  There are also natural remedies that can work for borderline problems that might not be useful at all for severe problems.  Drugs aren't always the thing that works best for a particular person.  All this is just food for thought, as again, nobody on here is a medical expert, but just giving you some alternatives since you are unsatisfied with what's happening now.  Peace.