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Hypertensive response to exercise(HRE) and sleep apnea
#1
Hypertensive response to exercise(HRE) and sleep apnea
I recently had a nuclear stress test and my blood pressure climbed to 228/70. The doctor had to give me an injection to get my blood pressure down. Apparently I have hypertensive response to exercise or HRE. I went home and did some research. It seems that there is no cure, the scientists have only speculated on why it happens and the people with sleep apnea are more prone to it.

Does anyone have any insight on this? I see my doctor next week.

Thanks,car54
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#2
RE: Hypertensive response to exercise(HRE) and sleep apnea
Car54

Hate to mention it, but are you sure your cardiologist is well-qualified in the matter at hand (or is more of a generalist) and you might benefit from a subject-matter specialist?
Do you have any underlying heart arrhythmias? 
Is there any noticeable cardiomyopathy or heart wall stiffness or abnormality?
Did your pulse rise significantly with the rise in your blood pressure?
Did your doctor do an echocardiogram or stress echo to see your left ventricle ejection fraction and blood flow?
Did your doctor do a blood panel and arterial gases, especially CO2) study at the same time? 
Did your doctor do a blood study especially on the oxygen-transport function?
Did your doctor rule out peripheral artery disease or narrowing of peripheral arteries? 

My initial bp issue was related to heart arrhythmia (Exercise-induced ventricular tachycardia and throwing PVCs, and PACs.) Under control with a class III antiarrhythmic and blood pressure meds -- with a pacemaker/defibrillator for additional protection.

Best of luck finding an underlying cause or a management protocol that works.

-- steve
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#3
RE: Hypertensive response to exercise(HRE) and sleep apnea
Here are the procedure results. I am not sure what it all means. I also have asthma, Copd and some emphysema. i am just trying to understand it all before I meet with the doctor.


.pdf   Scan_20190921 (4).pdf (Size: 51.19 KB / Downloads: 17)

Study Result
Impression
IMPRESSION:

1. No reversible changes suggestive of ischemia.

2. Fixed inferior-inferoseptal defect which could potentially be due to
prominent diaphragmatic attenuation. Perfusion defect not excluded.

3. Cardiac Risk Assessment: Low
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#4
RE: Hypertensive response to exercise(HRE) and sleep apnea
Thanks for sharing the report.

Other than the high bp and hypertensive response I don't see anything that jumps out -- but I am not a doctor, let alone a cardiologist.

I would ask the doctor if the general diagnosis is "Isolated systolic hypertension" and have underlying conditions such as artery stiffness, an overactive thyroid (hyperthyroidism), or heart valve problems been ruled out. I would also ask him about your fluid balance and the use of diuretics. I would also ask about the overproduction of red blood cells and high hematocrit levels associated with polycythemia vera which can contribute to systemic hypertension.

Since you use a CPAP, did you ask your doctor if the echo (if you had one) ruled out pulmonary hypertension?

Is this the only time you observed this phenomenon or has it occurred before?

I noticed that you are taking Valsartan which has been subject to recall, so you may want to check with your pharmacist if your batch was included.

Sorry, I can't be more specific other than to let you know what I have been told about my own issues. I have an underactive thyroid which has its own issues. And, I donate 500ml of blood every 6 weeks for polycythemia.

Have you considered a  multi-disciplinary diagnostician (not a general practitioner) who can put everything together?
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
RE: Hypertensive response to exercise(HRE) and sleep apnea
srlevine1,
 I appreciate your comments, I want to be prepared when I see the doctor. My valsartan is good. Yes it has happened before. I recently retired and my grandson talked me into exercising because I get very winded when I go above my normal range of activity which is rather active. I always blamed it on my lungs. I started checking my blood pressure right after exercising and many times it was well above 200. I don't know about an echo. I like the idea of a multi-disciplinary diagnostician.

Thanks again, car54
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