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Suggest Treatment For Headaches, Vomiting And High BP
Question: I've had a bad headache for the last 24 hours. Last night I started vomiting. I checked my blood pressure through the night. The readings were 194/128. 191/108. 193/116, 203/110. Is the high blood pressure causing the headache and vomiting? I take atacand, Coreg, and demadex for blood pressure and the doctor gave me procardia to take under my tongue when it goes up really high. I took two doses last night but it doesn't keep it down. Should I go to the ER if the blood pressure doesn't come down and stay down today?
Brief Answer:
You should ask immediate medical assistance to the nearest ER service.
Detailed Answer:
Hello!
Welcome back on HCM!
I passed carefully through your concern and would like to explain that your actual blood pressure values are quite high.
Your BP values are at the level of hypertensive crisis which is a dangerous condition that may be associated with several complications such as heart attack, cerebral bleeding, pulmonary edema, retinal impairment, kidney injury.
It is strongly recommended prompt intervention to decrease such high blood pressure values at least by 25% in the first hours.
You may try 1-2 doses of Procardia under the tongue and if the results are not satisfactory (BP values do not get under 160/90 mmHg), then you should immediately ask medical assistance at the nearest ER service in your living area.
In addition you should discuss with your attending doctor on the possibility of optimizing your anti-hypertensive therapy:
- Atacand should be up-titrated to the maximal daily dose of 32 mg.
- Coreg may be up-titrated gradually to 25 mg twice daily if well tolerated.
- a calcium channel blocker should be started in the maintenance therapy (Amlodipine, Lercanidipine 10 mg/day).
Also, some life-style modification should be applied : a healthy diet (DASH, Mediterranean diet), decrease body weight, perform frequent physical activity (at least 4 km walking daily), avoid close smoking contact.
You need to discuss with your doctor on the the above mentioned issues.
Meanwhile consider immediate blood pressure values control; if not at home run to the nearest ER service.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
You should ask immediate medical assistance to the nearest ER service.
Detailed Answer:
Hello!
Welcome back on HCM!
I passed carefully through your concern and would like to explain that your actual blood pressure values are quite high.
Your BP values are at the level of hypertensive crisis which is a dangerous condition that may be associated with several complications such as heart attack, cerebral bleeding, pulmonary edema, retinal impairment, kidney injury.
It is strongly recommended prompt intervention to decrease such high blood pressure values at least by 25% in the first hours.
You may try 1-2 doses of Procardia under the tongue and if the results are not satisfactory (BP values do not get under 160/90 mmHg), then you should immediately ask medical assistance at the nearest ER service in your living area.
In addition you should discuss with your attending doctor on the possibility of optimizing your anti-hypertensive therapy:
- Atacand should be up-titrated to the maximal daily dose of 32 mg.
- Coreg may be up-titrated gradually to 25 mg twice daily if well tolerated.
- a calcium channel blocker should be started in the maintenance therapy (Amlodipine, Lercanidipine 10 mg/day).
Also, some life-style modification should be applied : a healthy diet (DASH, Mediterranean diet), decrease body weight, perform frequent physical activity (at least 4 km walking daily), avoid close smoking contact.
You need to discuss with your doctor on the the above mentioned issues.
Meanwhile consider immediate blood pressure values control; if not at home run to the nearest ER service.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I went to the ER and was given hydralazine by IV. That was several hours ago and my blood pressure has come back up to 187/117. The doctor prescribed an increased dose of coreg to 12.5 mg twice a day and hydralazine pills to take if it elevates too high again. I've just taken the two pills so I don't know how soon to expect an improvement. The problem is a severe headache that I don't know whether is caused by the blood pressure or if it is a migraine. Is it safe to take maxalt to see if it relieves the pain? is there anything else I could take instead of the maxalt?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Hydralazine effects will show withing 20 minutes and it will show its maximum effect withing an hour. Coreg acts more slowly and it will show its maximal effect within 2 hours.
But, I would strongly not recommend taking maxalt, because it can trigger hypertensive crisis and it can lead to increased risk for possible stroke or myocardial infarction in this clinical situation.
If your situation does not improve, I recommend going back to the ER.
Hope to have been helpful!
Let me know about everything!
Wishing good health,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Hydralazine effects will show withing 20 minutes and it will show its maximum effect withing an hour. Coreg acts more slowly and it will show its maximal effect within 2 hours.
But, I would strongly not recommend taking maxalt, because it can trigger hypertensive crisis and it can lead to increased risk for possible stroke or myocardial infarction in this clinical situation.
If your situation does not improve, I recommend going back to the ER.
Hope to have been helpful!
Let me know about everything!
Wishing good health,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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