Hello -
First, yes, a diastolic pressure consistently above 100 is a concern. It's just not supposed to be that high very often (not even during vigorous exercise). So this needs to be resolved.
Your doctor is very likely right regarding your age. While blood pressure does tend (or at least historically it has) to increase with age, at 28 there's no innocent reason for your pressure to suddenly step up that way, and the underlying cause should be discovered if at all possible.
It's not always possible -- this is then called "essential"
hypertension -- but many times the cause can be found and corrected. It's woth a try to avoid having to be on BP meds for an extended period of time.
One thing that should be rule out due to the sudden onset of this problem is
pheochromocytoma -- a generally benign adrenal tumor. These tumors are often found right on the adrenal gland or glands, as one might expect -- but not always. This is why they are such a problem to discover: they're not always where they'd be expected. They can actually turn up anywhere inside the thorax, and the main problem with them is that they produce adrenaline, just like the adrenal glands. I suppose it goes without saying that when these are present, so is too much adrenaline, which can cause a sudden spike in blood pressure which may be chronic.
There are both blood and urine tests to determine if there is excess adrenaline in the body. If this is the case, the hunt starts for the tumors (which can be very tiny at times, and difficult to identify via usual imaging techniques). If this is the problem, it is usually quite fixable, and tests to rule this out or in should be done for sure.
Also, since there is a history of thyroid disease in your family, and since it doesn't matter whether it was hyper or hypo (since the disease can transpose from one generation to the next and even between siblings),
hyperthyroidism needs to be ruled out as well. This is neither as complicated to diagnose nor correct, but it definitely should be done, and quickly.
If these two possibilities are eliminated and there is not other evidence of kidney disease, then you'll probably be classifed as having "essential"
hypertension, at least for the time being, and treated symptomatically -- to control the blood pressure first and foremost. This is necessary anyway, and hopefully, eventually, the underlying cause will be discovered. Ideally it would turn up in the course of trying to rule out the disorders mentioned above.
I hope this is helpful to you. The bicuspid aortic valve (BAV) may have some obscure relationship with elevated blood pressure also, but there's no clear cause and effect. Still, if you do have a BAV you'll also need to be followed for possible development of an ascending
aortic aneurysm. Since you currently have high blood pressure, and since this is a risk factor for
aortic aneurysm independent of BAV, this is especially important to watch as well, so the diagnosis of BAV needs to be clarified and, if present, followed with at least an annual
echocardiogram.
Good luck to you. Please follow up with us as needed.
