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Suggest Treatment For High Blood Pressure

Posted on Mon, 27 Jul 2015

Question: I have essential high blood pressure as explained to me. I used to take Amlodipine 2.5, twice a day plus Hydrochlorothiazide - 25mg. It was causing swelling in the legs. Doctor changed to Cilnidipine - 10, Olmesartan - 10 with continued Hydrochlorothiazide -25. It stopped swelling but my systolic remains in the range of 145 /155 with Dystolic at 70 / 75 range. I am 74 with no other illness.

Should I increase the dosage of Cilnidipie OR Olmesartan?

Answered by Dr. Sukhvinder Singh (2 hours later)

Brief Answer:
not now!

Detailed Answer:
Dear Sir
1. At the age of 74 years the goal BP is 150/90 mmHg. A few readings marginally above this level should not warrant a change in dosage.
2. Any change in medication should be done by your physician only.
3. Whenever you check your BP, some rules must be adhered to. It should be done at nearly same time of day. You must not have consumed tea/ coffee/ cigarette in last one hour. You must not have exercised in last one hour. You must not be having any pain/ physical /psychological stress at that time.
Hope this helps.
Sincerely
Sukhvinder

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Sukhvinder Singh (13 hours later)

I am regular in my daily exercise with good health profile. My range of BP with Amlodipine was Systolic 125/140 & Dystolic 70/75 with Pulse range of 50/60. I am not smoker. I go through annual check-up with usual follow up supports to keep cholestral, B12, D3 observations to keep them at desired levels. I am not diabetic.
Change in Systolic as compared to earlier levels made me to ask this question.

I take care of the points mentioned in your reply while taking Blood Pressure. I also follow WHO guidelines of posture, waiting period etc.

You may wish to add your guidance after above review. I will go to my physician but it may happen after few months as I am at different location currently.

Answered by Dr. Sukhvinder Singh (9 hours later)

Brief Answer:
please see details below.

Detailed Answer:
Dear Sir
1. Any change in medication will take about 3 weeks to produce full effect. If it has been changed recently please wait for about 3 weeks.
2. If 7 out of 10 readings are below 150/ 90 mmHg , I would not change the medication in my patients of age more than 60 years.
3. If the readings are frequently more than 150/90 mmHg, then I would consider increasing the dose of drugs. But in that case you need to take a prescription from your local doctor.
4. I usually prefer increasing olmesartan in such a scenario over clinidipine.
Sincerely
Sukhvinder

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Sukhvinder Singh (14 hours later)

Thanks for response & guidance.

Change from Amlodipine to Cilnidipine happened more than 3 weeks period.

I contacted my Physician over phone in the meanwhile as advised by you & his advice matches with your advice to increase dosage of olmesartan from 10 to 20.

Thanks. I will close the discussion now.

Sincerely
XXXX

Answered by Dr. Sukhvinder Singh (2 minutes later)

Brief Answer:
you are welcome.

Detailed Answer:
You are welcome Sir.
Sincerely
Sukhvinder

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar