Suggest Medication To Control BP And Sugar

Posted on Sun, 21 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 21 Sep 2014 Answered on

Wed, 15 Oct 2014 Last reviewed on

Question : HI doctor

I am a T2diabetic for the last 12 yrs,on tablets, taking medicine for Hypertension and for TGL.My latest sugar report FBS145, PPBS198, HBA1C 8.o%,urine sugar+++.My lipids T Chl 172 , HDL...36....., LDL...106....., VLDL...30......and TGL ....151.... I am taking medicines Zoryl 2mg 1-0-1/2, Galvas50 0-1-0,Vogliboze 0-1-0, Telma 40 1-0-1,Cilakar 10mg 1-0-0,Supradyn 0-1-0, Meganueron OD Plus 0-0-1.My Blood pressure range Syst 150 and Diast 70.My weight 79kg, height 5.10inches.Daily walking 4kms, doing yoga other excercises, monitoring every 3 months, moderate diet control with less rice and no sugar consumption at all.I am a bit worried why my syst BP always stay above 145 despite strong medicines.Amlodipine does not suit me, so cilakar given.ECG done 6 months back, normal.No cardiac issues, breathing etc very clear.Do I need to change BP medicine?I dont want to add more and more medicines , already taking lots.

CAn u go through my case and guide / advise me as how can I bring my syt BP down and control sugar. MY Sr Creatinine was 1.7 , now it is 1.4.I am also taking T Fenofibrate 145 one daily . REgards PSN

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Further changes in treatment are needed...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concerns.

From what you are describing, further changes in your anti-hypertensive therapy are needed in order to bring bp less than 130/80. If you maintain such bp range, your risk to develop cardio-vascular/renal complications is lowered together with reduced mortality rate.

To achieve this goal, I advise to :
- an ARB (angiotensin-receptors-blockers) such as valsartan
- start a diuretic like hydrochlorothiazide
- take amlodipin and
- betablockers (e.g. atenolol)

You can discuss this further with your doctor to start changes as soon as possible.

Hope it helped!
Dr.Benard

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Benard Shehu (10 hours later)

HI doc,
Thank you for ur q reply.I am already taking Telmisartan 40mg twotablets daily (which is supposed to be the best in ARBs in india),
I had side effect of Amlodipine ankleswelling and rashes and so the here gave me Cilacar10mg(Clinidipine, a betterCCB),taking one tab daily.
Regardibg diuretic, I had taken chlorothiazide for a long time and my diabetologist asked me to stop that.
MY diabetologist is of the opinion that Betablockers are generally not prescribed to diabetics as blood sugar may go out of control.
IN view of the above, the reply to my question is not of any use .
Thanking you
PSN

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Lower high blood pressure

Detailed Answer:
Hi back,

Let me explain again you are a diabetic patient with high BP and the treatment guideline in your case is to lower BP below 130/80 mmHg. This is done in order to decrease overall morbidity and mortality especially the risk of developing renal failure, heart attack and stroke.

This is the golden standard of dealing hypertensive patients with diabetes, from what you are saying your problem are treated only by your diabetologist (which is an expert for diabetes but not for hypertension).

By the cardiologist point of view diuretics and betablockers aren't contraindicated in diabetes and in your case the recommendation are to lower BP. However consult a cardiologist for second opinion.

Amlodipin and Cilacar are both Ca channel blockers with the same effect (when I wright amlodipin I mean a ca channel blockers). As long as you developed ankle edema you should switch to Cilacar.

Hope this clarify you!
Dr. Benard

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju