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Dear Doctor Garu, Namaste.I Am 77 Year Old Male From

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Posted on Fri, 21 Aug 2020
Question: Dear Doctor garu,
Namaste.I am 77 year old male from vizag. I have had mild hypertension from the year 1980. I have been now taking Betacard 60 mg , Amtas 10 mg once a day.My hypertension is under control.Of late i am experiencing dizziness whenver i get up from the bed suddenly .My bp readings as under
XXXXXXX 2020 7.20 am 125/71 4pm 142/84
27th 7 am139/80 5.30 pm 130/77
28th 7 am113/72 5 pm 135/83
12th 9 ammay 122/72
24/5 131/80
4th aug 7 am116/73
My question is whether i have to stop amtas 10 mg and take Betacard 50 mg as there is fall in bp while i lie down.Or not necessary? kindly advise.
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Follow up: Dr. AJEET SINGH (0 minute later)
Dear Doctor garu,
Namaste.I am 77 year old male from vizag. I have had mild hypertension from the year 1980. I have been now taking Betacard 60 mg , Amtas 10 mg once a day.My hypertension is under control.Of late i am experiencing dizziness whenver i get up from the bed suddenly .My bp readings as under
XXXXXXX 2020 7.20 am 125/71 4pm 142/84
27th 7 am139/80 5.30 pm 130/77
28th 7 am113/72 5 pm 135/83
12th 9 ammay 122/72
24/5 131/80
4th aug 7 am116/73
My question is whether i have to stop amtas 10 mg and take Betacard 50 mg as there is fall in bp while i lie down.Or not necessary? kindly advise.
doctor
Answered by Dr. AJEET SINGH (3 hours later)
Brief Answer:
Life style changes can prevent postural hypotension.

Detailed Answer:
Hi....
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

There has been a good control of your high BP on the present drug regime.

The symptoms you are referring to are due to an entity called as Orthostatic hypotension (or postural hypo tension).
It occurs normally when we suddenly get up from supine position.
Due to redistribution of blood in lower body,there is decreased blood supply to brain and we feel dizziness.

Many anti hypertensive drugs cause an accentuation of postural hypotension and beta blockers(like Beta card)are quite notorious.

I would suggest you a few life style changes to nullify postural hypotension and significant fall in blood pressure.....
Keep yourself well hydrated by drinking plenty of water and oral fluids,avoid alcohol and caffeine (which cause dehydration),avoiding excess heat,eat small, low carb meals and use a small pillow (or no pillow) to avoid significant elevation of head end.
Whenever getting up from bed,take a side turn and get up slowly.
Wait for a few moments before starting to walk.

Any change in drug treatment should always be under medical supervision.
If the symptoms do not improve,see your cardiologist for further evaluation and change of management.

Hope that I have answered your query.

Stay healthy and stay blessed.
Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Life style changes can prevent postural hypotension.

Detailed Answer:
Hi....
Welcome to "Ask a Doctor" service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

There has been a good control of your high BP on the present drug regime.

The symptoms you are referring to are due to an entity called as Orthostatic hypotension (or postural hypo tension).
It occurs normally when we suddenly get up from supine position.
Due to redistribution of blood in lower body,there is decreased blood supply to brain and we feel dizziness.

Many anti hypertensive drugs cause an accentuation of postural hypotension and beta blockers(like Beta card)are quite notorious.

I would suggest you a few life style changes to nullify postural hypotension and significant fall in blood pressure.....
Keep yourself well hydrated by drinking plenty of water and oral fluids,avoid alcohol and caffeine (which cause dehydration),avoiding excess heat,eat small, low carb meals and use a small pillow (or no pillow) to avoid significant elevation of head end.
Whenever getting up from bed,take a side turn and get up slowly.
Wait for a few moments before starting to walk.

Any change in drug treatment should always be under medical supervision.
If the symptoms do not improve,see your cardiologist for further evaluation and change of management.

Hope that I have answered your query.

Stay healthy and stay blessed.
Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. AJEET SINGH (1 hour later)
Dear doctor saab
thank you for your advise. As you said , i use a very flat pillow . I get up from one side and sit for some time .I ll follow your advise. One more thing is for my age whats the limit of the bp readings.My wife is 70 yr old she takes Cilacar 10 mg.Her bp is normally between 140 and 150 and cystolic and 70 to 80 diaostolic. how far her bp readings can go ? is this normal.Kindly advise.
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Follow up: Dr. AJEET SINGH (0 minute later)
Dear doctor saab
thank you for your advise. As you said , i use a very flat pillow . I get up from one side and sit for some time .I ll follow your advise. One more thing is for my age whats the limit of the bp readings.My wife is 70 yr old she takes Cilacar 10 mg.Her bp is normally between 140 and 150 and cystolic and 70 to 80 diaostolic. how far her bp readings can go ? is this normal.Kindly advise.
doctor
Answered by Dr. AJEET SINGH (3 hours later)
Brief Answer:
Life style modification can prevent postural hypotension

Detailed Answer:
Welcome back.

As such,there are no specific upper limit values of blood pressure according to age but as per my clinical opinion,for you and your wife,a blood pressure of around 140/90 mm of Hg might be permissible.

In a known hypertensive,drug treatment should always be accompanied by de stressing techniques (like meditations and yoga),increased physical activity,salt restricted diet(less than 5 grams per day),mantainence of an ideal body weight,taking plenty of potassium rich fruits,avoiding caffeine and alcohol and quitting smoking.

Happy living.
Warm regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Life style modification can prevent postural hypotension

Detailed Answer:
Welcome back.

As such,there are no specific upper limit values of blood pressure according to age but as per my clinical opinion,for you and your wife,a blood pressure of around 140/90 mm of Hg might be permissible.

In a known hypertensive,drug treatment should always be accompanied by de stressing techniques (like meditations and yoga),increased physical activity,salt restricted diet(less than 5 grams per day),mantainence of an ideal body weight,taking plenty of potassium rich fruits,avoiding caffeine and alcohol and quitting smoking.

Happy living.
Warm regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. AJEET SINGH (14 hours later)
Dear doctor garu,Namaste.I donot kno whether i cn ask a question relating to my wife. If not please excuse me and you please do not give reply to me and may treat itas closed.My wife has mild hypertension from 1996.At that time she was prescribed stamlo 10 mg. till th eyear 2019 she is taking it and her bp readings never crossed 120/80.but in May 2019 she has swelling in both feet and the doctor has stopped amlodipine and prescribed clinidipine (cilacar) 10 mg. I have been constantly monitoring her readings but never after 2019 may her bp readings did not hsow 120/80 but oscillate between 140 to 155/ 70 to 80. There are no sellings lastyear itself within 10 days they were subsided. Her bp reading yesterday is 154/74. can she revert back to amlodipine and stop cilacar. If you allow this question give me your advise.
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Follow up: Dr. AJEET SINGH (0 minute later)
Dear doctor garu,Namaste.I donot kno whether i cn ask a question relating to my wife. If not please excuse me and you please do not give reply to me and may treat itas closed.My wife has mild hypertension from 1996.At that time she was prescribed stamlo 10 mg. till th eyear 2019 she is taking it and her bp readings never crossed 120/80.but in May 2019 she has swelling in both feet and the doctor has stopped amlodipine and prescribed clinidipine (cilacar) 10 mg. I have been constantly monitoring her readings but never after 2019 may her bp readings did not hsow 120/80 but oscillate between 140 to 155/ 70 to 80. There are no sellings lastyear itself within 10 days they were subsided. Her bp reading yesterday is 154/74. can she revert back to amlodipine and stop cilacar. If you allow this question give me your advise.
doctor
Answered by Dr. AJEET SINGH (1 hour later)
Brief Answer:
Cilacar is a good anti hypertensive drug with less side effects

Detailed Answer:
Hello Sir.

The most common side effects of Stamlo (Amlodipine) are headache, flushing, tiredness and swolling both lower limbs.
This pedal edema is due to arteriolar dilatation hypertension and fluid leak. This swelling do not resolve with diuretic drugs and the drug amlodipine needs to be withdrawn .
Cilacar is a good anti hypertensive drug(calcium channel blocker) which has fewer side effects.

Of course your wife's blood pressure readings are not satisfactory and requires a treatment of drug regime but this should only be done by a clinician after thorough clinical (physical) examination,investigation and evaluation.

Warm regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. AJEET SINGH (0 minute later)
Brief Answer:
Cilacar is a good anti hypertensive drug with less side effects

Detailed Answer:
Hello Sir.

The most common side effects of Stamlo (Amlodipine) are headache, flushing, tiredness and swolling both lower limbs.
This pedal edema is due to arteriolar dilatation hypertension and fluid leak. This swelling do not resolve with diuretic drugs and the drug amlodipine needs to be withdrawn .
Cilacar is a good anti hypertensive drug(calcium channel blocker) which has fewer side effects.

Of course your wife's blood pressure readings are not satisfactory and requires a treatment of drug regime but this should only be done by a clinician after thorough clinical (physical) examination,investigation and evaluation.

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

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

General & Family Physician

Practicing since :1994

Answered : 2151 Questions

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Dear Doctor Garu, Namaste.I Am 77 Year Old Male From

Dear Doctor garu, Namaste.I am 77 year old male from vizag. I have had mild hypertension from the year 1980. I have been now taking Betacard 60 mg , Amtas 10 mg once a day.My hypertension is under control.Of late i am experiencing dizziness whenver i get up from the bed suddenly .My bp readings as under XXXXXXX 2020 7.20 am 125/71 4pm 142/84 27th 7 am139/80 5.30 pm 130/77 28th 7 am113/72 5 pm 135/83 12th 9 ammay 122/72 24/5 131/80 4th aug 7 am116/73 My question is whether i have to stop amtas 10 mg and take Betacard 50 mg as there is fall in bp while i lie down.Or not necessary? kindly advise.