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Is BP Reading Of 151/113 A Cause For Concern?
Question: My 42 year old daughter's blood pressure is 151/113, after taking 3 Toprol today. Is there something else she can do to try and lower it.?
Brief Answer:
Adding another group medicine would be better , if no symptoms one can wait
Detailed Answer:
Hello ,
I am Dr Mody and I would be addressing your concern .
I would like to ask whether your daughter is 1) already a known case of hypertension and is she already on toprol or 2) today was the first time she had higher pressure and she took toprol for the first time .
In situation 1) because the pressure reading are in stage 2 hypertension, a combination of two drugs is advised rather than toprol alone , considering her age a ARB like valsaartan or CCB group like clinidipine should be added .
If she has already taken extra toprol no worries , 100 mg is routinely given , so even an extra dose in evening can be taken with watch out of pulse rate.
Also toprol is not the best anti hypertensive and it's indication are other than just plain hypertension.
2) it's not wise to suddenly decreasing the blood pressure unless she has some symptoms . As she has already taken 75 mg of toprol , it's better to wait .
Do give me some more information about her , if any symptoms , so I can guide you better .
feel free to ask if any clarification needed , I would be happy to help.
Regards Dr. Priyank Mody
Adding another group medicine would be better , if no symptoms one can wait
Detailed Answer:
Hello ,
I am Dr Mody and I would be addressing your concern .
I would like to ask whether your daughter is 1) already a known case of hypertension and is she already on toprol or 2) today was the first time she had higher pressure and she took toprol for the first time .
In situation 1) because the pressure reading are in stage 2 hypertension, a combination of two drugs is advised rather than toprol alone , considering her age a ARB like valsaartan or CCB group like clinidipine should be added .
If she has already taken extra toprol no worries , 100 mg is routinely given , so even an extra dose in evening can be taken with watch out of pulse rate.
Also toprol is not the best anti hypertensive and it's indication are other than just plain hypertension.
2) it's not wise to suddenly decreasing the blood pressure unless she has some symptoms . As she has already taken 75 mg of toprol , it's better to wait .
Do give me some more information about her , if any symptoms , so I can guide you better .
feel free to ask if any clarification needed , I would be happy to help.
Regards Dr. Priyank Mody
Above answer was peer-reviewed by :
Dr. Sonia Raina
Good evening, Dr. Mody. Thank you so much for your well-considered and in-depth answer, as well as your show of concern.
Yes, XXXXXXX is a known case of hypertension and has been on toprol for quite some time. She has quite a bit of stress in her life (2 6-year-olds and a 10-year-old), and she does volunteer work at their school several days a week.
She also took a 40mg citalopram, and as far as symptoms, she hasn't had any pain, but her chest feels tight. My primary reason for concern (well, other than 151/113 is a pretty high b/p) was that it's been in the 150+/100+ range all day.
My first suggestion was for her to go to the ER (I just spent 7 hours in the ER Friday evening for chest pains), which, of course, she was reluctant to do. I had a heart attack in Feb. of last year, and she seems to follow my patterns. I am not familiar with the drugs you mentioned, but I'm researching them while waiting for your advice.
Your advice is very easy to understand, so I don't think clarification is needed, but definitely, I appreciate the opportunity for follow-up. If there are any other questions, please let me know. I look forward to seeing what you advise from this point.
Thank you so very much.
XXXX XXXXXXX
Now 157/107
Yes, XXXXXXX is a known case of hypertension and has been on toprol for quite some time. She has quite a bit of stress in her life (2 6-year-olds and a 10-year-old), and she does volunteer work at their school several days a week.
She also took a 40mg citalopram, and as far as symptoms, she hasn't had any pain, but her chest feels tight. My primary reason for concern (well, other than 151/113 is a pretty high b/p) was that it's been in the 150+/100+ range all day.
My first suggestion was for her to go to the ER (I just spent 7 hours in the ER Friday evening for chest pains), which, of course, she was reluctant to do. I had a heart attack in Feb. of last year, and she seems to follow my patterns. I am not familiar with the drugs you mentioned, but I'm researching them while waiting for your advice.
Your advice is very easy to understand, so I don't think clarification is needed, but definitely, I appreciate the opportunity for follow-up. If there are any other questions, please let me know. I look forward to seeing what you advise from this point.
Thank you so very much.
XXXX XXXXXXX
Now 157/107
Brief Answer:
100 mg toprol at present, consider adding another drug , evaluate furthur
Detailed Answer:
Hello ,
I Would be precise to answer :
1) I still am of opinion that a combination of anti hypertensive medication should be put as they have different mechanism of action and has addictive benefit , not just decreasing blood pressure but also protecting heart brain and kidney against ill effects of hypertension.
Angio tensin reception blocker group with small dose diuretic would be ideal for her .
2) toprol has been pushed as class 2 anti hypertensive by XXXXXXX / European heart association. (It also adds slightly her depressive moods)
Of similar group bisoprolol would be more ideal for her .
3) Temporary toprol 100 mg per day can be continued.
4) some relaxation from her stress levels is of utmost importance as till me remove the cause , adding to anti hypertensive dosage is not worth .
5) let me know your country so I can guide you with prevelant treatment padigrams
of hypertension locally
5) Very low salt in diet 2-3 gm / day
6) citalopram is known to cause water retention which may have resulted in higher pressure reading .
So I had suggested that diuretic
7) yes because of her family history we should be extra careful , as she is young and we should look for things till about 25 more years.
8) If she is overweight some reduction in weight should be considered.
9) some evaluation to find any precipitating cause , why suddenly a rise
10) also missing dose of toprol can push your pressure very high . So take care about the same
I am always on the other side for now and future .
Let me know if smallest of the doubt s and I would be happy to clarify .plz excuse me about time schedule as I run an extremely busy schedule.
Wishing her best of health.
Regards Dr. Mody
100 mg toprol at present, consider adding another drug , evaluate furthur
Detailed Answer:
Hello ,
I Would be precise to answer :
1) I still am of opinion that a combination of anti hypertensive medication should be put as they have different mechanism of action and has addictive benefit , not just decreasing blood pressure but also protecting heart brain and kidney against ill effects of hypertension.
Angio tensin reception blocker group with small dose diuretic would be ideal for her .
2) toprol has been pushed as class 2 anti hypertensive by XXXXXXX / European heart association. (It also adds slightly her depressive moods)
Of similar group bisoprolol would be more ideal for her .
3) Temporary toprol 100 mg per day can be continued.
4) some relaxation from her stress levels is of utmost importance as till me remove the cause , adding to anti hypertensive dosage is not worth .
5) let me know your country so I can guide you with prevelant treatment padigrams
of hypertension locally
5) Very low salt in diet 2-3 gm / day
6) citalopram is known to cause water retention which may have resulted in higher pressure reading .
So I had suggested that diuretic
7) yes because of her family history we should be extra careful , as she is young and we should look for things till about 25 more years.
8) If she is overweight some reduction in weight should be considered.
9) some evaluation to find any precipitating cause , why suddenly a rise
10) also missing dose of toprol can push your pressure very high . So take care about the same
I am always on the other side for now and future .
Let me know if smallest of the doubt s and I would be happy to clarify .plz excuse me about time schedule as I run an extremely busy schedule.
Wishing her best of health.
Regards Dr. Mody
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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