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SYMPTOMS OF HYPERPERTENSION even with ESAM-AT.

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hi
I am a 39 years old patientold male,

I am a hypertension patient using Esam-AT 50 mg tablet everyday, but still I am feeling symptoms of hypertension. My Blood pressure is 130/90 when I checked today evening. I hav taken tablet in the morning. Pls suggest Wat to do ?

Feeling symptoms like head ache , breathless, cramps , sleepless, especially in nights while sleeping

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 20 Doctors Online

Hello.
Thank you for your query at DoctorSpring.com.

I understand your concern and will do my best to help you.
A value of 130/90 mmHg is acceptable and your BP seems to be under control. The symptoms you are experiencing do not seem to be due to hypertension.

However, I would like some additional details in order to provide a definitive opinion.
- Since when do you have these symptoms?
- Since when do you have hypertension and since when are you taking Esam-AT ?
- Can you please describe the headache in detail? Please mention the duration of the headache, site of pain (one sided/ entire head/ front/ back etc), type of pain (dull/ throbbing/ piercing), aggravating factors (bright lights/ noise etc), relieving factors (medications/ rest etc).
- When you say breathless, do you feel this all the time or only on exertion? If on exertion, after what activities do you feel breathless? Any associated wheeze?
- Have you anytime woken up from sleep, gasping for breath and needed to go to a window etc for fresh air?
- When you say cramps, can you please specify the site affected?
- Was a full work-up done when you were diagnosed with hypertension?
- Any history of other medical conditions like asthma, diabetes etc?

Please reply to each of the above questions in the follow-up.

Awaiting your response,

Regards.


Patient replied :

Hello sir
(Q) Since when do you have these symptoms?
(A) since three months

(Q) Since when do you have hypertension and since when are you taking Esam-AT ?
(A) since one month and am taking tablet Esam-AT after breakfast

(Q) Can you please describe the headache in detail? Please mention the duration of the headache, site of pain (one sided/ entire head/ front/ back etc), type of pain (dull/ throbbing/ piercing), aggravating factors (bright lights/ noise etc), relieving factors (medications/ rest etc)?
(A) Normally when i go to sleep, back side of my head is paining. i feel like shooting pain in middle of my head, i feel like as if my nerves are pulling, i can say it is a piercing pain. even i cant see bright light or listen to noise which will be irritating.
i want to take rest alone at that time, if it is still severe then i will take desprin

(Q) When you say breathless, do you feel this all the time or only on exertion? If on exertion, after what activities do you feel breathless? Any associated wheeze?
(A) i feel breathlessness on exertion, when i take few steps to stairs or walk about 20 meters

(Q) When you say cramps, can you please specify the site affected?
(A) fingures of both hands, and foot

(Q) Was a full work-up done when you were diagnosed with hypertension?
(A) I went to a cordiologist two months back, he was our family doctor, he checked my BP then it was about 170/140, then he diognosed me with some tests like ECG which was normal, as i got family history of hypertension he suggested to take Esam-AT, i used for a month and checked regularly but my BP is showing 130/90 every time. then i stopped for a month taking Esam-AT for a week and checked, then also my pressure was 130/90, so i stopped taking tablet. again when these symptoms (head ache, cramps, some shooted pain in head and shoulder) i went to doctor then he told not to stop tablet. so i started taking it again since 10 days but still my problems are not soloved (head ache, cramps, some shooted pain in head and shoulder, faster heat beat some times)
(Q) Any history of other medical conditions like asthma, diabetes etc?
(A) no diabetes at all till now, at the age of 5 to 12 years old patienti had asthama i used some homeopathi medication at that time and that was cured completely, i never had it again after 12th year

regards


Hello.
Thank you for your response.

After going through all your history, I am of the opinion that your symptoms are non-specific. By this, I mean to say that they do not fit into a single diagnosis.
The headache, sleplessness, cramps etc might be anxiety-induced, especially if you have had been dealing with a lot of stress lately.
Feeling out of breath after walking for 20 metres or climbing stairs can be due to low level of fitness and since you have already have been examined by your doctor, nothing to worry about it.

I have the following recommendations.
1. Please undertake some de-stressing activities like yoga, meditation, or whatever works for you.
2. You need to make sure you have a salt and oil restricted diet.
3. Please undertake at least 30 minutes of walking for at least 5 days a week.
4. As for your BP medication, instead of the combination of Amlodipine + Atenolol, you can take just Amlodipine after consultation with your doctor.
If your symptoms persist even after a week of following the above measures, please see your doctor.

I hope this was helpful.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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