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Suggest Treatment For High Blood Pressure And Pulse Rate
Question: I had a high blood pressure incident last nite with initial BP reading of 180/102 (yikes) plus arrhythmias and pulse over 120. I took a clonidine.1mg as instructed if BP over 170. The systolic reading dropped to 139 but bystolic remained around 100 for next two hours along with racing pulse and arrhythmias. I took my usual evening dose of 25 mg spironolact and 10 mg bystolic and eventually fell asleep. This morning was 148/72.
What are the dangers of this sustained high bystolic reading? Any idea why this is happening? (not the first time) I am also very swollen in my lower extremities and took a Lasik this morning.
Thank you for your help.
What are the dangers of this sustained high bystolic reading? Any idea why this is happening? (not the first time) I am also very swollen in my lower extremities and took a Lasik this morning.
Thank you for your help.
Brief Answer:
Increase furosemide dose
Detailed Answer:
Hello, madame. Thank you for your question and welcome to Health Care Magic. I understand your concern.
The diastolic blood pressure sometimes reflects the level of stress you are experiencing, especially when you find a phenomenon to be worrisome to yoi. Blood pressure figures you provided are not normal and should be kept under control. Also the increase in heart rate is probably from this worrisome event that happened to you. If you have an enlarged heart (provided by the echocardiogram findings, if done) then it is expected to have swollen ankles, but, also, treated with additional dosage of furosemide or, at least, adding it to your therapy. It would both provide better blood pressure control and control of the swollen ankles. If the echocardiogram was not carried out, then I would suggest that it should be done, along with an EKG to evaluate the heart electrical and conduction systems, at resting state. Proper medical approaches should be undertaken to keep the blood pressure under 140/90 mmHg. If you do not have an enlarged heart, then nebivolol can be switched to a beta-blocker that also has heart rate-controlling properties (atenolol, metoprolol) along with blood pressure-lowering properties. It is also important to exclude the cardiac origin of the swollen ankles, as it can also come from kidney issues. A single or occasional spikes of blood pressure can happen to anybody even in physiological states, such as physical activity, paychological stress, after having caffeine-containing beverages. However, it is crucial, as I mentioned above, that proper medical adjustments or additions should be done, to keep the blood pressure figures under the above-mentioned figures.
I hope this is helpful. I am happy to help, if you have follow-up questions. Please rate the answer, if you do not. Wish you a good health.
Best regards,
Dr. Meriton
Increase furosemide dose
Detailed Answer:
Hello, madame. Thank you for your question and welcome to Health Care Magic. I understand your concern.
The diastolic blood pressure sometimes reflects the level of stress you are experiencing, especially when you find a phenomenon to be worrisome to yoi. Blood pressure figures you provided are not normal and should be kept under control. Also the increase in heart rate is probably from this worrisome event that happened to you. If you have an enlarged heart (provided by the echocardiogram findings, if done) then it is expected to have swollen ankles, but, also, treated with additional dosage of furosemide or, at least, adding it to your therapy. It would both provide better blood pressure control and control of the swollen ankles. If the echocardiogram was not carried out, then I would suggest that it should be done, along with an EKG to evaluate the heart electrical and conduction systems, at resting state. Proper medical approaches should be undertaken to keep the blood pressure under 140/90 mmHg. If you do not have an enlarged heart, then nebivolol can be switched to a beta-blocker that also has heart rate-controlling properties (atenolol, metoprolol) along with blood pressure-lowering properties. It is also important to exclude the cardiac origin of the swollen ankles, as it can also come from kidney issues. A single or occasional spikes of blood pressure can happen to anybody even in physiological states, such as physical activity, paychological stress, after having caffeine-containing beverages. However, it is crucial, as I mentioned above, that proper medical adjustments or additions should be done, to keep the blood pressure figures under the above-mentioned figures.
I hope this is helpful. I am happy to help, if you have follow-up questions. Please rate the answer, if you do not. Wish you a good health.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for your input, Dr. Meriton. I have recently (60 days ago) had an echocardiogram at my 6 month check up with my cardiologist. It was perfectly normal. Also an EKG one month ago when I went to the ER with the worst headache of my life and BP numbers even higher than above. That was also normal. What is nebivolol and would it replace the spironolact.
My primary concern is why the dystolic BP does not respond to the other meds I am taking in the situation I outlined above. There was no stress or other indicator Friday nite - just having a nice dinner with girlfriend. Similar situation one month ago except blasting headache.
What is the physical danger to having a dystolic reading that high for a sustained period of time? Thank you for your help.
My primary concern is why the dystolic BP does not respond to the other meds I am taking in the situation I outlined above. There was no stress or other indicator Friday nite - just having a nice dinner with girlfriend. Similar situation one month ago except blasting headache.
What is the physical danger to having a dystolic reading that high for a sustained period of time? Thank you for your help.
Brief Answer:
Probably none
Detailed Answer:
Welcome back and hello again.
The Bystolic you are taking is nebivolol, a good and effective beta-blocker which controls effectively the blood pressure. While it has negligable effect on the heart rate, there are other beta-blockers that also affect the heart rate (mentioned in my first answer). Headaches can be triggered by spikes of high blood pressure. I recommend you to treat them with OTC NSAIDs and the results will be appearent within few days. The diastolic blood figures you provided, are not harmful for the organism, since they are casual findings. My opinion is that not only stressful events cause increasing of te blood pressure, but also every phenomenon that causes you stress and is interpreted as worrisome phenomenon. It takes only "that much" for the adrenalin to spike in the system and give you the high blood pressure and high heart rate. With the recommendations I provided in my first answer, I think that the blood pressure will be stabilized.
I hope this helps. If you do not have further questions, close the discussion and rate the answer. Wish you a great health,
Kind regards,
Dr. Meriton
Probably none
Detailed Answer:
Welcome back and hello again.
The Bystolic you are taking is nebivolol, a good and effective beta-blocker which controls effectively the blood pressure. While it has negligable effect on the heart rate, there are other beta-blockers that also affect the heart rate (mentioned in my first answer). Headaches can be triggered by spikes of high blood pressure. I recommend you to treat them with OTC NSAIDs and the results will be appearent within few days. The diastolic blood figures you provided, are not harmful for the organism, since they are casual findings. My opinion is that not only stressful events cause increasing of te blood pressure, but also every phenomenon that causes you stress and is interpreted as worrisome phenomenon. It takes only "that much" for the adrenalin to spike in the system and give you the high blood pressure and high heart rate. With the recommendations I provided in my first answer, I think that the blood pressure will be stabilized.
I hope this helps. If you do not have further questions, close the discussion and rate the answer. Wish you a great health,
Kind regards,
Dr. Meriton
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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