A 30-Year-Old IT Professional: Treating Fear, Not Blood Pressure

In the OPD, a 30-year-old IT professional came for a second opinion. He was diagnosed with Metabolic syndrome and Vitamin B12 deficiency. Reviewing his history and current treatment, it was noted that he had been on combination Blood Pressure medicines for 3-4 years. Today, his Blood Pressure was 120/80, stable, and had been normal for several days, yet the dose remained the same.

When asked about his lifestyle, he admitted: No walking? ❌ No post-meal walk? ❌ No sunlight exposure? ❌ No stress handling? ❌ Only medicines and fear.

At the end of one prescription, there was a line: “If Blood Pressure reaches 130/90, your nearby doctor should call me.”

Reading that, one thing became strikingly clear to me: - Here, Blood Pressure was not being treated. - Here, fear was being treated… with medicines.

A 30-year-old young man gets scared even if his Blood Pressure rises slightly, because a notion had been firmly instilled in his mind: “Blood Pressure must always be 120/80.”

Lifestyle was never discussed. There was no thought of reducing the dose. No observation, no patience. Just Fear + Medicine = Treatment.

And what was the meaning of that line, “GP should call me”? Does it mean a General Practitioner is just a messenger? He sees the patient, does follow-ups, but has no authority to make decisions? Do all problems get solved with a single phone call to a senior name?

This is not clinical management. This is hierarchy-driven medicine. And it is dangerous.

Today’s science is clear. AHA / ESC / ESH state that in the early stages, with borderline Blood Pressure or metabolic issues, the focus should first be on lifestyle modifications. Dose titration should be done based on observation. And many times, medicine can be reduced, sometimes even stopped.

But here, there is no lifestyle. There is fear. And the equation is that safety means only medicine.

Today, I did not see a patient with increased Blood Pressure. I saw a patient with increased fear. And unfortunately… this is very common.

Dr. Ravindra L Kulkarni MD, DNB, FSCAI (Cardiology) Just For Hearts