Brief Answer:
A better BP control is necessary to avoid long term complications

Detailed Answer:
Hello dear Sir!

Welcome and thank you for asking on HCM!

Regarding your blood pressure issue, I would like to explain that blood pressure is a silent killer. It keeps damaging your entire blood vessels slowly and continuously.

So never think that you are are immune to a stroke or heart attack.

Blood pressure can be harmless only if properly controlled under an adequate therapy.

So the right thing to do is to investigate potential secondary causes of resistent high blood pressure and adjust an antihypertensive scene accordingly.

A compressive medical evaluation is necessary to accomplish this purpose.
A careful physical examination coupled with a resting ECG, chest x ray and several blood tests should be done: a complete blood count, thyroid hormone levels, liver and kidney function tests, blood electrolytes, fasting glucose etc..

If a secondary cause for maintaining high blood pressure is identified, than this disorder should be properly addressed by prescribing the proper treatment options.

You have to discuss with your attending physician about the above mentioned issues.

If no secondary causes are identified, then a modulation of your primary (idiopathic) hypertension therapy should be considered.

If no contraindications are present other hypertensive class medications may be added (ACE, ARB, Thyazides etc.).
You need to discuss with your doctor to find the right solutions.

Hope to have been helpful!

Feel free to ask any questions whenever you need.

Best wishes,
Dr.Iliri

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Brief Answer:
I would recommend as follows:

Detailed Answer:

Hi again Dimitrios!

As I actually don't know the exact adverse implication of diabetes and hypertension on your possible renal function impairment, I would advise to be careful with Metformin and Zapril as they should be avoided in the presence of renal disease.

If such a renal disease is confirmed by lab tests and actually it is important (more than stage III), then Gliclazide should be avoided too.

In such case the best therapeutic option for your diabetes would be insulin.

You need to check too HBA1c (glycosylated hemoglobin to verify how controlled has been lately your diabetes) and discuss with your doctor (internist or endocrinologist) for possibly starting insulin.

Regarding hypertension, I recommend you to check the above mentioned tests, and if secondary causes of hypertension are revealed, to adjust the therapeutic strategy appropriately.

You need to discuss with your attending doctor about this, as it remains on his discretion to make the right decision for your health.

Hope to have been of help!

Best regards,

Dr. Iliri

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