Suggest Treatment For High Blood Pressure

Posted on Fri, 9 Jun 2017

Question: I am taking lisinopril and couple of days after my flight from USA to Europe my BP went up to 235 over 78. What i should do to lower my blood pressure immediately. I took lisinopril 40mlg in the morning and 20mlg at about 9pm and another dose of 20mlg at midnight. Usually I take one douse of 40mlg a day and my BP is about 135/78 and some times little higher but not so much as today. Please let me know what to do. Thanks.

Answered by Dr. Sagar Makode (31 minutes later)

Brief Answer:
Need additional medicine, tab Amlodipine 5 mg once a day

Detailed Answer:
Hello,

You may need additional antihypertensive like tab Amlodipine 5 mg once a day. You should monitor Blood pressure thrice a day for at least a week and if blood pressure stays above 140/90mmhg, we need to increase the dose of Amlodipine to 10 mg once a day.

Lisinopril in such a high dose of 80mg should be avoided.

You should also undergo kidney function test, renal artery Doppler and morning 8 am serum cortisol levels in order to find the cause for high bp. Also, get your sugars, Lipid profile tested once.

Have low salt diet and regular exercises.

Hope this helps you and please get back if you have any doubts.
Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Sagar Makode (17 minutes later)

Hello doctor,
I am sorry, but I did not have complete information from my wife. She is also taking the Amplodipine 10mg a day and also Metoprolol Tart 100mg a day.

Answered by Dr. Sagar Makode (4 minutes later)

Brief Answer:
Need to add tab Minipress XL 5 mg once a day

Detailed Answer:
No issues, since her requirement of antihypertensive, is very high, it's important that she should undergo evaluation for the causes. In addition to what I advised above, she should also undergo 24hr Urinary metanephrines levels.

Now, next step is to add Tab Minipress (Prazosin) XL 5 mg once a day, if it fails to control then we will increase it to 10 mg once a day.

Please discuss this with her Cardiologist and proceed further.

All the best.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Sagar Makode (20 minutes later)

Thank you doctor,
it looks like her BP is heading right direction. Since her additional last pill of Lisinopril 20mg at midnight, her reading is down from high of 235 to 168/75 and pulse 64. It is now 1:30am here and I will be monitoring her BP every hour.
Thank you for your answer and we will be following up on your recommendation after our return to US. Also we will be trying avoid 80mg off Lisinopril. I was looking on the internet and discovered that 80mg is XXXXXXX for a day.
So I am thanking you and have a good night, XXXXXXX XXXXXXX

Answered by Dr. Sagar Makode (1 minute later)

Brief Answer:
Thanks and all the best

Detailed Answer:
You're most welcome

Thanks and all the best.

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

Above answer was peer-reviewed by : Dr. Arnab Banerjee