[jyl]

Interested in the docs' thoughts on my recent medical issues.

I've had essential hypertension for my adult life. When it was first diagnosed, at age 35, my BP was 150/100 and resting pulse 100 bpm. Was put on atenolol, a beta blocker, which took my BP to 140/80 and resting pulse to 80 bpm.

Fast forward to a few years ago, I was cycling a lot and found my pulse upon first waking was 40 bpm, which seemed too low. I went off the beta blocker and my BP stayed 145/85 average over the day, resting pulse 60 bpm. Higher in the mid afternoon, lower in the morning and evening. My other labs were a little off, LDL and TG moderately high, HDL moderately low.

Fast forward to now, and I find myself going to the doctor because I'd noticed my BP was way high. Like 180/110 mid day, never lower than 160/100, and my resting HR was around 65 bpm. Also had gained about 5 lb and was cycling a little less, still the daily bike commute but sort of cruising more and hammering less, and being less diligent about the weekend rides.

My doctor asks me a bunch of questions and does a physical exam, that was obviously designed to look for signs of a stroke. None. He does an EKG, which suggests left ventricular hypertrophy. He sends me for an echocardiogram, which reports back "mild left ventricular hypertrophy" but no sign of "hypertrophic cardiomyopathy". Puts me back on HBP meds, this time lisinopril, an ACE inhibitor. BP is back down to 150/90 and resting pulse 55 bpm. We are still adjusting the dose higher, a little at a time and currently 20 mg/day, but I may not want to go to a much higher dose because now if I get up suddenly from the couch, I am sometimes slightly light headed. Surprisingly to me, all my other labs are fine - lipid panel, metabolic panel, blood sugar, TSH, serum uric acid are all well within normal ranges.

He tells me there is no need to restrict activity, so my plan for the summer is to ride more, drop 5-10 lb, spend a few hours a week at 150-180 bpm. Oh, and I've checked my life insurance and made sure my wife knows the policy info and all the passwords to all the accounts and so on. I'm 52 y/o.

What should I think about this? Should I be concerned, worried, anxious, freaked?