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Obese female with high diastolic BP on exercise

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I am a 34 year old female, obese, and have been seeing a personal trainer for the last 3 weeks. Yesterday, we checked my blood pressure in the middle of a high intensity workout. It was 138 / 108. I understand that the systolic pressure will rise during exercise, but not the diastolic. I'm scared now. I just moved to a completely new city and can't find a doctor. On the internet, it says it likely heart failure or coronary artery disease. Though my pharmacist said that it is likely normal for this rise considering my weight along with the intense exercise. I checked my BP this morning at a local pharmacy after walking fast paced from my car, it was 133 / 103, then I waited about 5 minutes, relaxed and checked again. It was 126 / 86. Do I need to be concerned? I don't have any other symptoms - no chest pain, no dizziness, no nausea. But I do get a really bad throbbing headache when I am doing exercise where I am bent over.

Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.


Thank you for your query at Doctorspring.com.

First of all.. Relax! Your symptoms are not those of heart failure or Coronary artery disease. You have intermittent records of high BP. Here is some advice for you.

Get a 24 hour ambulatory BP recording done. That will clarify if you have high BP all the time or it was just a blip during the exercise. Though I fully agree that your Diastolic BP shouldnt be so high during exercise. So if possible get this test done.

If the test is not available in this area do not worry. Follow the next step
Reduce your weight. How? Reduce the calorie intake. Suppose you have 3 chapatis and rice replace one chapati and some portion of rice with salads, green leafy vegetables, sprouts, legumes. Increase your calorie expenditure. The exercise regime you follow should be aerobic exercise without too much straining. Walking brisk or running cycling swimming should be a good exercise for you. Do not try weight lifting or pulling heavy loads. Eat a lot of fruits citrus one. Replace your salt with low sodium salt. reduce salt intake in food. avoid pickles and packed foods.

These should reduce your BP.
Reassessment after 3 months. Either get a repeat ambulatory BP monitoring or get BP recorded by some doctor.

If your symptoms increase in between (before completing 3 months) get a BP measurement in between when you have symptoms. If it stays high we shall start you on medications and advice you some blood tests and ECHO.

Hope this helps, please feel free to discuss further.

Dr Vivek Mahajan

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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