Thank you for your query at DoctorSpring.com.
Since you can perform heavy work without any distress and considering your young age and absence of any traditional risk factors coronary artery blockages are extremely unlikely to be present. A TMT or stress test would be fruitless.
You are correct that the diastolic bp should fall during exercise which doesn't happen in your case.
It could be called a hypertensive exercise response.
But it doesn't signify that you have coronary blockages. It may mean that your peripheral resistance doesn't decrease after exercise as it should normally. This may indicate that you may be at risk of developing diastolic hypertension which is common in middle aged people. The treatment guidelines for hypertension are based on resting bp and elevated exercise bp doesn't warrant treatment.
So my advice is that despite your family history you need to avoid being anxious about coronary artery disease. Take preventive measures against hypertension. Increase fruits nuts and whole grain intake. Sprouts n green leafy vegetables should help.
Continue exercising and monitor your bp 6 monthly at rest.
Hope this helps, I would be glad to answer any follow-up queries.
Dr Vivek Mahajan
Patient replied :
Hi again thanks for the quick response it helps put my mind somewhat at ease. One more thing i forgot to mention is that i noticed a slight diagonal ear lobe crease in my right ear, from what ive read this seems to be predictive for future cardiovascular problems. This along with an hypertensive response to exercise would indicate im at high risk for the development of hypertension and coronary artery disease later in life. I will follow your suggestions on diet and exercise, i also take fairly high doses of fish oils and vitamin c. with taking these risk factors into consideration how likely is it i will develop blocked arteries in the future? once again thanks for your help.
It is just an observation that people with earlobe crease have more incidence of coronary artery disease. It is an observation coming down from old textbooks. But I have not come across a proper longitudinal study wherein people with earlobe crease were compared with normal population.
As of now we shall take it that you maybe at a greater risk of future hypertension and perhaps cad because of your family history. If that leads you to take precautions then I am happy. Vit c isn't beneficial as per evidence available.
Follow the health advice religiously and you may then stop worrying about the future.
Dr Vivek Mahajan