Heart Health: Make sure you're getting EKG's, watch your BP

[ChemBB]

Wanted to share my recent EKG results.

BP as-measured was 152/76. Hypertension-induced cardiac remodeling yielding significant LVH is current diagnosis.

Do your cardio, friends. I ordered a smart watch to track 24/7 HR and BP and am going back to doing 30m cardio daily...

• Summary: Normal systolic & diastolic function; concentric LVH (thick walls, normal cavity).
• Concentric LVH with preserved function. Pattern strongly fits pressure overload (hypertension, heavy-lift afterload)

Metric	Your value	Typical reference (adult male)	Interpretation
EF (biplane)	55 %	52–72 %	Normal systolic function
LVIDd	53 mm (5.3 cm)	~4.2–5.9 cm	Normal cavity size
IVS / PWT	14 / 14 mm	~6–10 mm	Increased wall thickness
Relative wall thickness = 2×PWT/LVIDd	0.53	>0.42 = concentric	Concentric geometry
LV mass index (BSA)	166 g/m²	Normal ≤115; mild 116–131; mod 132–148; severe ≥149	severe
LA volume index	29.9 mL/m²	≤34 mL/m²	Normal filling pressures
E/A (82/64 cm/s)	1.28	~0.8–2.0	Normal pattern
e′ (Ea)	13 cm/s	≥10–12 cm/s typical	Normal relaxation
E/e′	7	<8 normal; >14 elevated	Normal LV filling pressure
TR Vmax / RVSP	1.98 m/s / ~19 mmHg	RVSP <35 mmHg	Normal PA pressure
RV S′ (TDI)	16 cm/s	≥9.5 cm/s	Normal RV systolic function

 

[Nidus]

Whats your blood pressure med regimen? Doctor putting you some stuff already?

If not, i can highly recommend eating a ton of Ubiquinol 300-400mg+ together with injectable Carnitine and a Beta Blocker like Nebi.

Buddy in my gym got his LVH (was 17mm) down to 12mm with this (ofc some additional BP meds on top like Telmisartan at 80mg + an SLGT2 and another one which i dont remember its name)

 

[Photon]

Wanted to share my recent EKG results.

BP as-measured was 152/76. Hypertension-induced cardiac remodeling yielding significant LVH is current diagnosis.

Do your cardio, friends. I ordered a smart watch to track 24/7 HR and BP and am going back to doing 30m cardio daily...

• Summary: Normal systolic & diastolic function; concentric LVH (thick walls, normal cavity).
• Concentric LVH with preserved function. Pattern strongly fits pressure overload (hypertension, heavy-lift afterload)

Metric	Your value	Typical reference (adult male)	Interpretation
EF (biplane)	55 %	52–72 %	Normal systolic function
LVIDd	53 mm (5.3 cm)	~4.2–5.9 cm	Normal cavity size
IVS / PWT	14 / 14 mm	~6–10 mm	Increased wall thickness
Relative wall thickness = 2×PWT/LVIDd	0.53	>0.42 = concentric	Concentric geometry
LV mass index (BSA)	166 g/m²	Normal ≤115; mild 116–131; mod 132–148; severe ≥149	severe
LA volume index	29.9 mL/m²	≤34 mL/m²	Normal filling pressures
E/A (82/64 cm/s)	1.28	~0.8–2.0	Normal pattern
e′ (Ea)	13 cm/s	≥10–12 cm/s typical	Normal relaxation
E/e′	7	<8 normal; >14 elevated	Normal LV filling pressure
TR Vmax / RVSP	1.98 m/s / ~19 mmHg	RVSP <35 mmHg	Normal PA pressure
RV S′ (TDI)	16 cm/s	≥9.5 cm/s	Normal RV systolic function

Thats an echo right?
Not an EKG.

 

[ChemBB]

Whats your blood pressure med regimen? Doctor putting you some stuff already?

Currently I take 200mg Labetalol (beta blocker) in the AM and PM

When I was cutting and doing daily cardio my BP was much better.

I always have high resting heart rate + BP, runs in my family =(
HR and BP only come down to normal if I do daily cardio.
And I hate cardio =/

Might ask doctor for an ACE Inhibitor, I have a followup to discuss EKG results in 2 weeks

i can highly recommend eating a ton of Ubiquinol 300-400mg+ together with injectable Carnitine and a Beta Blocker like Nebi.

Seems like CoQ10 has decent evidence behind it lowering systolic BP:

Effects of coenzyme Q10 administration on blood pressure and heart rate in adults: A systematic review and meta-analysis of randomized controlled trials

Thanks, I will add 200mg a day I think based on the paper's summary:

"The pooled analysis of 45 RCTs (48 effect sizes) showed that Q10 administration significantly reduced systolic BP (WMD: −3.44 mmHg; 95 %CI: [-5.13 to −1.55], p < 0.01), while no significant effect was observed on diastolic BP (WMD: −1.13 mmHg; 95 %CI: [-2.16 – 0.50], p = 0.23) and HR (WMD: −0.10 bpm; 95 %CI: [-2.09 – 1.89], p = 0.44). Subgroup analysis indicated that lower doses (<200 mg/day) and longer interventions (>8 weeks) resulted in greater systolic BP reductions."

 

[ChemBB]

Thats an echo right?
Not an EKG.

Yeah, my mistake -- they both have similar names and acronyms, so I get them mixed up often

 

[Nidus]

Currently I take 200mg Labetalol (beta blocker) in the AM and PM

When I was cutting and doing daily cardio my BP was much better.

I always have high resting heart rate + BP, runs in my family =(
HR and BP only come down to normal if I do daily cardio.
And I hate cardio =/

Might ask doctor for an ACE Inhibitor, I have a followup to discuss EKG results in 2 weeks



Seems like CoQ10 has decent evidence behind it lowering systolic BP:

Effects of coenzyme Q10 administration on blood pressure and heart rate in adults: A systematic review and meta-analysis of randomized controlled trials

Thanks, I will add 200mg a day I think based on the paper's summary:

Co10 is amazing for the heart, although you should get it as Ubiquinol and run it at high doses, all heart trials were at 400mg and higher, at least the ones i came across

Nebivol also might be a bit more beneficial for LVH but best to check with your doc.
Carnitine has also shown promising results to prevent the progression of LVH and aid in reversal there

As for Cardio i do 15 mins of stairmaster at max. speed and max difficulty, feels like a kick in the nuts but made me drop my BP meds by half within 2 months of doing it

And defo look into SLGT2's!

 

[Ghoul]

BP is easy to control for the vast majority.

Plenty of flowcharts that guide decision making on medication choice. Same process doctors use.

99% can get it to ideal range with no side effects, often in one combo pill, by taking the time to dial in the correct meds.

No need for a very complicated regimen.

 

[ChemBB]

Co10 is amazing for the heart, although you should get it as Ubiquinol and run it at high doses, all heart trials were at 400mg and higher, at least the ones i came across

I dug into this briefly and it seems like meta-analyses of all published studies point towards a U-Shaped dose response curve with 100-200mg giving optimal BP benefit:


Dose-Response Effect of Coenzyme Q10 Supplementation on Blood Pressure among Patients with Cardiometabolic Disorders: A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials

Importantly, a U-shaped dose-response relation was observed between CoQ10 supplementation and SBP level, with an approximate dose of 100–200 mg/d largely reducing SBP (χ2 = 10.84, P nonlinearity = 0.004). .... The current finding demonstrated that the clinically beneficial effects of CoQ10 supplementation may be attributed to the reduction in SBP, and 100–200 mg/d of CoQ10 supplementation may achieve the greatest benefit on SBP in patients with cardiometabolic diseases.

 

[ResuNona]

I see you were interested in asking your doctor for an ACE inhibitor. If you are hesitant to take more drugs have you considered asking them about the mechanism of an ARB (telmisartan, suffix'ed "sartan" drugs) for the studied benefits of potentially reversing LVH; in combo-therapy with your beta-blocker versus an ACE inhibitor?

Just a different approach. Obviously talk with your doctor who will pull your bloods to monitor your potassium, etc when committing to what potentially may amount to necessary polypharmacy to manage your condition...

https://www.ahajournals.org/doi/10.1161/01.CIR.0000141573.44737.5A

...Losartan-based therapy induced greater reduction in LVMI from baseline to the last available study than atenolol with adjustment for baseline LVMI and blood pressure and in-treatment pressure (−21.7±21.8 versus −17.7±19.6 g/m2; P=0.021)..

https://www.amjmed.com/article/S0002-9343(03)00158-X/abstract

...left ventricular mass index decreased by 13% with angiotensin II receptor antagonists (95% confidence interval [CI]: 8% to 18%), by 11% with calcium antagonists (95% CI: 9% to 13%), by 10% with ACE inhibitors (95% CI: 8% to 12%), by 8% with diuretics (95% CI: 5% to 10%), and by 6% with beta-blockers (95% CI: 3% to 8%). In pairwise comparisons, angiotensin II receptor antagonists, calcium antagonists, and ACE inhibitors were more effective at reducing left ventricular mass than were beta-blockers...

You are also monitoring your lipids too I'd hope.

 

[explodingHeart]

Is that really you in your profile picture? You're shredded out of your mind.

What PEDs are you taking that are pushing up your BP?

 

[RockyP]

We all need to be doing daily cardio. There's just no way around it. Doesn't matter what your BF% is. And I mean cardio with a lowercase c, meaning it could be just steps / LISS for most of the week, but with some intensity in there either via your resistance training (i.e on leg day my HR averages 125 bpm for 90 mins straight - much rather do that than sprinting or the erg machine). HTN is like everything else, genetic predisposition plus environment. Even the most shredded of those on here might have been dealt a shitty hand in that dept. For me, even when maximally bulked to 270 range, my BP never ran over 130/75. My HDL on the other hand commits suicide at the site of a test vial.

Test your blood pressure daily. Don't get nuts about one isolated reading but watch the trend. If it stays elevated for a week while checking first thing in the AM, pursue it. Educate yourself (on this board and elsewhere) on management strategies (such as Pitavastatin + / - Zetia vs other statins for lipids), find a competent provider (this is likely the hardest part) who will work with you to get you these tests. It may be overkill depending on your age (and hard to get covered by insurance), but a CACC (Calcium score) is another important test to have and track over time.

Stay healthy fellas.

 

[Jeffholio5]

Anyone have any good tips for getting an echocardiogram for a reasonable price paying out of pocket?

 

[ChemBB]

I see you were interested in asking your doctor for an ACE inhibitor. If you are hesitant to take more drugs have you considered asking them about the mechanism of an ARB (telmisartan, suffix'ed "sartan" drugs) for the studied benefits of potentially reversing LVH; in combo-therapy with your beta-blocker versus an ACE inhibitor?

You are also monitoring your lipids too I'd hope.

Telmisartan is a great idea, thanks for the reminder. You can also get it from sources frequently so it's a bit easier to acquire than some alternatives.

I'm generally of the mind that "Take more drugs to combat the side effects you are having from taking too many drugs" isn't the best approach though

I already dislike being on a beta blocker, especially because of the mild performance impairment they give

Ideally I'd like to have my BP and lipids under control entirely through diet and exercise but when on AAS depending on genetics it's not always possible...

And yes absolutely monitoring lipids

Recently heard of a new subscription blood service for $79/mo that tests markers I usually pay about $250 for with PrivateMD Labs

Might give them a shot

https://rythmhealth.com

 

[ChemBB]

Is that really you in your profile picture? You're shredded out of your mind.

What PEDs are you taking that are pushing up your BP?

Ha -- thank you

Currently on 750 Test + 100 Trest, but I have hereditary BP + lipid problems

 

[ChemBB]

We all need to be doing daily cardio. There's just no way around it. ... Even the most shredded of those on here might have been dealt a shitty hand in that dept.

Amen. I had my genome sequenced and I've got about 12 different SNP's that cause hyperlipidemia, hypertension, and cardiac events

So there's just no way around me having to aggressively stay on top of it for life, and I'm still likely going to die from a cardiac-related event or cancer

Test your blood pressure daily.

I bought a Galaxy Watch 7 and jailbroke it to enable BP and ECG monitoring so I'll have 24/7 data on HR + BP and arythmia/AFIB

 

[ChemBB]

Anyone have any good tips for getting an echocardiogram for a reasonable price paying out of pocket?

Any reason why you can't ask your Cardiologist to do one?

I finally told my Cardiologist that I use AAS and specifically asked to check for LVH

 

[BamaCrazy]

Anyone have any good tips for getting an echocardiogram for a reasonable price paying out of pocket?

You can check this website. Play around with the distance from home parameters to get better results.

RadiologyAssist | Nationwide access to affordable MRI, CT, Xray, Ultrasound, PET, and mammogram

Nationwide Affordable and low cost MRI, CT, Xray, Ultrasound, PET and Mammogram for the uninsured

radiologyassist.com

 

[ResuNona]

Any reason why you can't ask your Cardiologist to do one?

I finally told my Cardiologist that I use AAS and specifically asked to check for LVH

Perhaps on the basis of you having LVH and using BCBS insurance policies as a presumptive framework; I think would be an easy articulation to your insurance company on behalf of your doctor to request for you. I'd just login to your insurance portal.

https://www.bluecrossma.org/medical-policies/sites/g/files/csphws2091/files/acquiadam-assets/115 Transthoracic Echocardiography (TTE).pdf

..Ventricular Function, Cardiomyopathies and Heart Failure TTE is considered MEDICALLY NECESSARY for the following: 1. When the etiology is in doubt, echocardiography can document or rule out the common cardiaccauses of pulmonary congestion left-sided valvular disease, depressed systolic or diastolic function,and cardiomyopathy. In this regard, echocardiography is the preferred initial diagnostic test when thehistory, physical examination, and routine laboratory tests suggest (or cannot eliminate) cardiac..

Also have you considered simply telmisartan mono-therapy and asking your doctor to titrate you from the lowest dose? ARBs are shown simply to be more effective than beta-blocks at reducing blood pressure.

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16402

Several meta-analyses have concluded that efficacy of β-blockers in hypertension is inferior compared with other classes of antihypertensive drugs: ACE (angiotensin-converting enzyme) inhibitors, angiotensin receptor blockers (ARBs), calcium-channel blockers (CCBs), and thiazide or thiazide-like diuretics (TDs).<a href="

Atenolol in hypertension: is it a wise choice? - PubMed

Our results cast doubts on atenolol as a suitable drug for hypertensive patients. Moreover, they challenge the use of atenolol as a reference drug in outcome trials in hypertension.

pubmed.ncbi.nlm.nih.gov

..Despite major differences in blood pressure lowering, there were no outcome differences between atenolol and placebo in the four studies, comprising 6825 patients,...

If you take a beta-blocker for situational performance effects you can dose that PRN.

 

[ChemBB]

I'd never heard of TTE, interesting -- thanks

I'll bring up this procedure and Telmisartan in my followup with my Cardio

 

[explodingHeart]

Amen. I had my genome sequenced and I've got about 12 different SNP's that cause hyperlipidemia, hypertension, and cardiac events

So there's just no way around me having to aggressively stay on top of it for life, and I'm still likely going to die from a cardiac-related event or cancer

I bought a Galaxy Watch 7 and jailbroke it to enable BP and ECG monitoring so I'll have 24/7 data on HR + BP and arythmia/AFIB

My dad was obese most of his life with one foot in the grave from his lifestyle, he eats butter straight from the stick. His diet is pure garbage.

Yet his ldl was 60 and hdl 66. Purely genetic.