Just wondering if this situation is unusual. My cholesterol is pretty low, ~130 when it was checked 6 months ago. Don't remember the HDL/LDL ratio, but it was also good. My blood pressure, however, is usually 145-150/90 and resting heart rate around 46. Is this kind of combination normal? I need to lose about 10 pounds, but I'm in relatively good shape with high muscle content, body fat percentage around 14%. I'm also 29. Think I'll have to go on blood pressure medication as even when I was at 6% body fat in my early 20s, my BP was in the 140s. Mom's side has history of high blood pressure.

not really. blood pressure tends to do its own thing and we don't really understand why, seems like it is probably genetics.

i'm 27 with a pretty similar history to you except my bf is probably 20%. losing a few pounds isn't gonna fix it though.

First, I'd defer to the doctors on this board, but from my own experience, I'd have an internist check you out.

150/90 bp is not great and should be controlled a little better. Your internist can find the cause whether it is Na or K imbalance, aldosterone/renin problem or others. Untreated hypertension can cause real damage to one's heart's ability to pump efficiently over the long term.

You don't want to wake up one day @55 with an irregular heartbeat and find yourself in the emergency room because you neglected something so easy to treat for 30 years.

Also, do you run or swim competitively as a hr of 46 is pretty rare among non serious athletes.

Thirdly, what sort of diet do you eat to maintain a 130 total cholesterol?

OP - ask your doctor about a 24 hour ambulatory monitor if you haven't already. When you say your blood pressure is usually 145-150/90 is this taken at home or in a clinical setting? Your family history indicates that you could have high blood pressure, but you don't want to go on blood pressure medication unnecessarily.

Disclaimer: I am not a doctor; however, I had a number of higher readings both at home and when I was in the doctor's office. I was 181/100 when I put the ambulatory monitor on, but I wore it for 24 hours and my average turned out to be 120/70 dropping as low as 106/60something during sleep.

I had some problems with blood pressure in my late 20's also, but in my case losing 10 lbs. had a very big effect. I am not disputing your experience, but I am making the point that blood pressure is kind of tricky so it is not good to over generalize.

Are you measuring your BP yourself at home? If so, make sure that you have a large enough cuff. You sound like you're in good shape, so you probably have larger than average biceps. The standard cuffs are only good for 9-13 inches unflexed which is basically a pus arm. If your arm is too big, the cuff will appear to fit, but the readings will not be accurate. You need to buy the larger cuff sold separately which is good for up to 17 inches. The store machines are inaccurate to begin with, and they are also only for up to 13 inch arms. I went for a time thinking that my BP was too high when it was perfectly normal. It seems very unlikely that you have a 46 pulse, which is excellent, with low body fat, and have high blood pressure.

Another thing, don't make a fist when your pressure is taken at home or at the doctor's office. It will make it higher, and the dumbass nurses won't even notice. Also, sit quietly for a few minutes before you take it. Think about fat women on the beach.

Yes, losing 10 pounds can make a significant difference, and it also changes significantly from moment to moment.

These measurements are typically those machines they have in the pharmacies, and I've done that at home one a few times as well. That was my next question about arm circumference, as mine is 14-14.5 inches unflexed. For the heart rate, I've been a competitive athlete all my life and was a national level decathlete in undergrad and half of grad school. I don't work out as hard, but my resting heart rate hasn't ever been measured above 53 or so.

As for diet, when I was competing, I ate a very healthy diet, primarily lean proteins, vegetables, whole grains, etc. I'm beginning to watch my diet again more closely, but ate pretty poorly the last few years. Low cholesterol runs on my dad's side as he is 75 and has cholesterol in the 140s with no medication. I'm going to get an appointment with a doctor. A 24h measurement sounds like a good idea. The low cholesterol/high blood pressure seemed like an odd combination to me.

Your arm is too big for the in-store machines. They say right on the machine that they are only good up to 13 inches. Don't trust those. Get your own with the larger cuff, and avoid the really cheap ones because the cuffs are cheaply made. It's usually the analog ones from the pharmacy that tend to be very cheap, so get a digital one. The cuff should be sturdy like the ones at the docs office, not cheap fabric that can get twisted and pinched. Don't make a fist, and sit still for a few minutes first. If you are like me, I predict that your pressure will read normal. Mine read like yours before I got the right cuff. Then I read 120/80 (normal). BTW, statistically, mortality rates increase for anything above 110/70, so shoot for that.

The notion of being a top class decathalete certainly explains the pulse. Blood pressure is more a function of electrolyte balance and protein levels like renin an angiotensin than cholesterol levels. Your internist will be able to evaluate this properly.

As stated above those in store machines are garbage. You probably have a lower pressure and higher heart rate than you think you do, which means as much as you want to be a special snowflake you probably aren't

I hope my bp is lower, I'm getting it checked next week. 46 looks low for the heart rate. It was 50 in the emergency room and usually in the low 50s when I measure it myself. However, my bp was also in the 140s in the emergency room a couple months ago by a nurse, and I assume those are reasonably accurate, so now I'm not sure.

Many people's bp is higher at the doctor's office due to nervousness. If you were in the ER, I assume you were injured or sick which could raise it. Try to take it first thing in the morning, and not right after you eat or drink something.

OP you might (probably) have high blood pressure. It's not the end of the world and is easily treatable. Not sure why we're all going through mental gymnastics to explain away the high readings. Get some drugs. Don't sweat it. Hydrochlorothiazide is the most commonly prescribed medication in the USA.

Whitecoat hypertension is quite common. Putting someone on blood pressure meds when they don't actually require them can have negative consequences such as dropping your blood pressure too low. That is why OP should first of all have a doctor diagnose him with high blood pressure. No one is saying he for sure doesn't have high blood pressure.

I had similar readings to the OP and then had a 24 hour blood pressure monitor put on and was an average of 120/70. I'm not a doctor, but I'm not sure why any doc would put a young person on blood pressure meds before screening for other possible causes such as white coat or hyperthyroidism.

Quick tip, when you go to get your BP taken, make sure you can sit in the chair for 5 minutes before they take it, also make sure the inflatable part of the cuff (the bladder/balloon part) makes it at-least 80% of the way around your arm.

Our med school preceptors told us something like 70% of healthcare providers routinely incorrectly take blood pressure and those are two of the most common mistakes that can give bad readings.

And making a fist which they don't notice. Happened to me all the time.