[45F] With high blood pressure and swollen lower legs and feet

Patient Description

A 45-year-old female has been experiencing swelling in her lower legs and feet for the past four weeks, with the swelling being worse on the left foot and lower leg. Sometimes her toes get red, but the swelling is not hot or painful. She also discovered she has high blood pressure a couple of weeks ago, with a reading of 156/107. She does not feel any symptoms from the high blood pressure and is not currently taking any medications for it. Smoking seems to exacerbate her blood pressure. She has not experienced any sudden severe headaches, changes in vision, chest pain, or shortness of breath. Additionally, she does not have any other symptoms or pre-existing conditions and is not taking any medications. She has a family history of hypertension, heart disease, and strokes.

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Arora's Assessment

What might be happening

Based on the information you've provided, several possible conditions could explain your symptoms:

  • Hypertension (High Blood Pressure): Your blood pressure reading of 156/107 is significantly elevated. High blood pressure can lead to fluid retention, which might explain the swelling in your lower legs and feet.

    • Treatment: Lifestyle changes such as reducing salt intake, quitting smoking, and regular exercise can help manage high blood pressure. Medications may also be prescribed by your doctor.
  • Chronic Venous Insufficiency: This condition occurs when the veins in your legs are not working effectively, making it difficult for blood to return to the heart. This can cause swelling, particularly in the lower legs and feet.

    • Treatment: Compression stockings, elevating your legs, and avoiding prolonged periods of standing or sitting can help. In some cases, medications or procedures to improve vein function may be necessary.
  • Congestive Heart Failure: This condition can cause fluid buildup in various parts of the body, including the lower legs and feet. Given your family history of heart disease, this is a possibility that should be evaluated by a healthcare provider.

    • Treatment: Medications, lifestyle changes, and in some cases, surgical interventions are used to manage heart failure.
  • Lymphedema: This is a condition where the lymphatic system is unable to properly drain lymph fluid, leading to swelling. It often affects one limb more than the other.

    • Treatment: Compression garments, physical therapy, and in some cases, surgical options are available to manage lymphedema.

What you can do

While you should consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Elevate Your Legs: Try to keep your legs elevated above the level of your heart for 15-30 minutes several times a day to reduce swelling.
  2. Reduce Salt Intake: High salt intake can contribute to fluid retention. Aim to reduce your salt consumption.
  3. Quit Smoking: Smoking can worsen high blood pressure and contribute to cardiovascular issues. Seek support to quit smoking.
  4. Stay Active: Gentle exercises like walking can help improve circulation and reduce swelling.
  5. Monitor Your Blood Pressure: Keep a log of your blood pressure readings to share with your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden, severe swelling or pain in your legs
  • Shortness of breath or chest pain
  • Sudden severe headache or changes in vision
  • Signs of infection, such as redness, warmth, or fever

Remember, while these tips can help manage your symptoms, they are not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation and appropriate treatment.

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5 mo ago


People Also Ask


What causes swelling in the lower legs and feet?

Swelling in the lower legs and feet can be caused by various conditions, including chronic venous insufficiency, congestive heart failure, lymphedema, and fluid retention due to high blood pressure.


How can high blood pressure lead to swelling?

High blood pressure can lead to fluid retention in the body, which may cause swelling in the lower extremities. This is because the increased pressure can affect the kidneys' ability to remove excess fluid efficiently.


What lifestyle changes can help manage high blood pressure?

Lifestyle changes that can help manage high blood pressure include reducing salt intake, quitting smoking, engaging in regular physical activity, maintaining a healthy weight, and managing stress.


What are the risks of untreated high blood pressure?

Untreated high blood pressure can increase the risk of serious health problems such as heart disease, stroke, kidney damage, and vision loss. It is important to manage blood pressure to reduce these risks.

1 Comments


Prerana#31484

5 mo ago

Looking at your symptoms, it is important to emphasize that Hypertension, once diagnosed, must be well controlled with the correct medications. A formal visit to a physician is of utmost importance. It is also crucial to maintain a blood pressure diary of atleast 3 to 4 reading per week to understand your BP trend and titrate medication accordingly.

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