Blood Pressure Question

[jhess191050]

Started 200 MG Test Cyp 8 weeks ago, got bloods back.
Lipid Panel:
Total Cholesterol: 107
HDL: 45
Triglycerides: 53
LDL: 49

Alkaline Phosphate: 62
AST: 16
ALT: 12
GGT: 20

Hematocrit: 41.1

DHEA: 195
Prolactin: 13.7
SHBG: 27

Total Test:1119
FREE Test: 258.5

E2 sensitive: 78
(not taking an AI)

i made a post yesterday and mentioned i have struggled with ankle edema.
Well prior to starting TRT i noticed my BP was always running 130/75 … 134/75… sometimes it’ll be 128/75.
Not much change since starting TRT despite the edema, it hasn’t seemed to have changed much, i’m still in that range.

OTHER NOTES: When i went to the ER for the edema (i panicked) they ran all kinds of tests.
My ECG came back with these notes: NORMAL SINUS RHYTHM NONSPECIFIC ST AND T WAVE ABNORMALITY ABNORMAL ECG NO PREVIOUS ECGS AVAILABLE
I brought this up to my doctor and he said he reviewed it & it was nothing of concern.

High sensitivity troponin: Value: 2.1


D Dimer: 210


A few questions:
A. What’s the best way to get an accurate view of my BP. Meaning, when should i check it, how many times in a row should i check it? Any specifics such as that?
Also: Assuming i am running in that 128 / 135 systolic range, should i proactively be looking to start taking a BP med?
I’ve already lost 70 pounds and changed my lifestyle fully, i’ve changed my diet & do daily cardio (30 minutes incline treadmill).
One major problem, i am still in the process of quitting smoking, im down from a pack a day to 8 a day. i know for a fact this isn’t helping my issue but i am quitting, i just need to take the final leap to stop.
Family History: Father and Grand father both had heart attacks at 60 or so. I’m 34, i’m just trying to get on top of this stuff now.

Any suggestions on how to proceed would be greatly appreciated aside from the obvious that i need to quit the smoking, it’s my last bad habit and i’m almost there!


Full labs attached.
Ankle Edema photos attached.

 

[rxzed]

Started 200 MG Test Cyp 8 weeks ago, got bloods back.
Lipid Panel:
Total Cholesterol: 107
HDL: 45
Triglycerides: 53
LDL: 49

Alkaline Phosphate: 62
AST: 16
ALT: 12
GGT: 20

Hematocrit: 41.1

DHEA: 195
Prolactin: 13.7
SHBG: 27

Total Test:1119
FREE Test: 258.5

E2 sensitive: 78
(not taking an AI)

i made a post yesterday and mentioned i have struggled with ankle edema.
Well prior to starting TRT i noticed my BP was always running 130/75 … 134/75… sometimes it’ll be 128/75.
Not much change since starting TRT despite the edema, it hasn’t seemed to have changed much, i’m still in that range.

A few questions:
A. What’s the best way to get an accurate view of my BP. Meaning, when should i check it, how many times in a row should i check it? Any specifics such as that?

Try to do it at the same time everyday.

Tips to measure your blood pressure correctly - Harvard Health

Want to make sure your blood pressure is in a healthy range? Discover the experts' take on how to measure blood pressure correctly with these simple steps....

www.health.harvard.edu

Also: Assuming i am running in that 128 / 135 systolic range, should i proactively be looking to start taking a BP med?

Yes, 20mg Telmisartan would probably be a good start, or potentially 6.25mg chlorthalidone given the edema.

I’ve already lost 70 pounds and changed my lifestyle fully, i’ve changed my diet & do daily cardio (30 minutes incline treadmill).
One major problem, i am still in the process of quitting smoking, im down from a pack a day to 8 a day. i know for a fact this isn’t helping my issue but i am quitting, i just need to take the final leap to stop.

Nothing wrong with pharmaceutical intervention while you change your lifestyle.

Family History: Father and Grand father both had heart attacks at 60 or so. I’m 34, i’m just trying to get on top of this stuff now.

An ounce of prevention is worth a pound of the cure. Definitely a good idea.

Any suggestions on how to proceed would be greatly appreciated aside from the obvious that i need to quit the smoking, it’s my last bad habit and i’m almost there!

Seems like you already are on track and know what needs to be done. You're LDL is good, which is especially important with smoking.

 

[Ghoul]

Are you taking any meds now?

Those lipids look good but with your family history of heart attacks I wonder if you have sky high Lp(a), which is genetic and can cause heart attacks even with seemingly normal LDL.

 

[BALLISTIC]

Try to do it at the same time everyday.

Tips to measure your blood pressure correctly - Harvard Health

Want to make sure your blood pressure is in a healthy range? Discover the experts' take on how to measure blood pressure correctly with these simple steps....

www.health.harvard.edu

Yes, 20mg Telmisartan would probably be a good start, or potentially 6.25mg chlorthalidone given the edema.

Nothing wrong with pharmaceutical intervention while you change your lifestyle.

An ounce of prevention is worth a pound of the cure. Definitely a good idea.

Seems like you already are on track and know what needs to be done. You're LDL is good, which is especially important with smoking.

All this, preferably take you reading in the a.m. upon waking. You're in the most relaxed state.

 

[jhess191050]

Are you taking any meds now?

Those lipids look good but with your family history of heart attacks I wonder if you have sky high Lp(a), which is genetic and can cause heart attacks even with seemingly normal LDL.

i always see you commenting on these and you seem to be the guy with the knowledge on this so i’m happy to see your comment. Should i add a lp(a) / apob for my next draw just so i know where i stand.

as far as current meds, the only thing im taking other than TRT is Tirzepatide / Fish Oil / Magnesium Complex W D3 / Zinc. Other than that just Celexa for general anxiety.
My doctor looks at me like i’m crazy when i ask for consideration to take something proactively for BP control. He keeps saying oh lifestyle changes & i don’t know how many times i can tell him i’ve done all the life style changes, the only place he has me is the 8 cigarettes a day that i need to quit.

 

[Thecarrier]

Telmisartan first and if not enough take Telmisartan + diuretic

 

[buck]

At your BP ranges most dr wont prescribe anything. Lifestyle change is the standard medical protocol. What you are doing can lead to better readings in the future. Learning to manage stress can help a lot as well.

 

[Burly]

Would concider one forusamide 40mg early morning. Twice a week with Triamterene/Hydrochlorothiazide 25 mg / 12.5 mg for ‘Potassium saving’