Family, Internal Medicine, General Medical Questions/BP


Hi doc. Iím a 43 year old healthy male. Iím 5-11, 175, nonsmoker. Iím about 14% body fat, work out 5 days a week to include weight lifting and a run/walk of 3-4 miles daily. I eat relatively healthy to include nuts, fruits, veggies, low fat and high protein. I have had an issue with anxiety for years (severe health type anxiety and white coat syndrome). I get yearly physicals and have had the same physician for 10 years. My cholesterol runs high normal. My father had heart bypass at age 57 and Iím always concerned (probably obsessively concerned) about my health. I have seen a cardiologist (he sees me yearly now and always does a 12 lead EKG) for heart palpitations ( for a decade) that come and go. Here is my question. For years my blood pressure had been in normal to ďpre hypertensiveĒ area. My doc has me check at home due to very high readings in his office ( severe anxiety when at office). My blood pressure at home is typically normal to pre hypertension (130ís/80ís). The last two weeks I have been getting some high readings ( top number in 140ís bottom number is 80ís). I havenít had a reading that was to ridiculous high. Iím trying everything I can to avoid BP medicine at my age. I do everything I should. I sometimes get very anxious, even at home, when I take my BP. I think this may be affecting the readings because if I check it again- its always lower. AT what point do you recommend medications?


Yours is an interesting case. Generally speaking, risk of heart disease is based on gender, family history, and lifestyle. You are male which gives you 1 point, you have a family history which gives you 1 point, but your lifestyle takes away 1 point. My concern is how often are you anxious enough to cause your blood pressure to elevate. With anxiety, the vessels in the body constrict causing the heart to pump blood through narrow vessels. This is why you blood pressure elevates. When you are calm, your vessels are relaxed and your heart is pumping blood through dilated vessels causing no unnecessary pressure on your heart. Depending on your heart rate, their are medications that you may benefit from to keep the pressure in your heart lower. I would discuss some options with your doctor.  

Family, Internal Medicine, General Medical Questions

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Dr. Pamela M. Cipriano, DNP, APRN


My name is Dr. Cipriano. I have a private practice specializing in adult health and wellness. I can answer questions associated with thyroid disease, cardiac disease, pulmonary disease, high blood pressure, muscular aches and pains, cholesterol levels, male/female sexual questions or questions on the sexual organs, gastrointestinal problems, healthy ways to lose weight and maintain a healthy lifestyle, and nearly anything else that pertains to medicine.


I am on the Medical Staff at a local hospital where I work as a medical/surgical hospitalist as well as in the emergency department. I am certified in critical care and advanced cardiac life support. Prior to becoming a Nurse Practitioner, I was a certified critical care nurse (CCRN).

Society of Hospital Medicine American Association of Critical Care Nurses American Association of Nurse Practitioners Connecticut Advance Nurse Practitioner Society

Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Critical Care Certified 2014 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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Named as a World Wide Leader in Healthcare and was included in the 2013-2014 edition by the International Nurses Association.

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