Suggest Treatment For Persistent Hypertension And Dizziness

Posted on Thu, 29 Sep 2016

Question: I am a 52-year-old female. I have had a hysterectomy at the age of 35 and also had one ovary removed. I have been in good health - no diabetes, blood pressure, thyroid. I have been having menopausal symptoms for the past 5 years - hot flashes, irritability, for which I am taking no medication. They spike and subside. Two years ago, I had a complete blood work done - all tests were normal, except vitamin D, which was low and for which I took treatment in the form of two monthly injections. At the same time, i had a slightly high blood pressure reading, for which the doctor did not suggest any medication except, control on sodium intake. Occasional blood pressure readings i took thereafter were normal almost always 110/70 or 120/80.
About 7 months ago, i had fever and also noticed slight throbbing in the head - back side and temples, as well as occasional dizziness. I had my blood pressure checked - it was 180/100. The doctor suggested Diligan 25, which I took for two days. He thought the spike was related to menopause. After about a week/10 days, I had my blood pressure checked and had a normal reading 120/80. Since then occasional readings have again been normal 110/70 to 120/80.
Now, about a week ago, i again felt similar symptoms. Also felt a slight breathlessness - like having a take a deep breath occasionally and feeling breathless while having a long conversation or doing my yoga exercises. I had my blood pressure checked - it was now 160/100. So, i took Diligan 25 for three days, after which i stopped, when I read online that it was an anti-histamine. Since stopping the medication, i have felt okay, but not 100% alright - notice occasional symptoms.
I wonder now, if I am on the right track and would like your advice on the correct line of treatment, as well as on any medications I should take - regular or SOS. Should I continue with the Diligan?? I have not been able to get my blood pressure reading done again....plan on getting it tomorrow.

Appreciate your advice and suggestions on what

Answered by Dr. Deepti Verma (49 minutes later)

Brief Answer:
Do regular blood pressure monitoring and lifestyle modifications

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.

For persistent hypertension with BP >140/90, you need medications.
If salt restriction and exercise maintains blood pressure in normal range, then no need of medications.

Get regular BP monitoring as such fluctuations need to be recorded and investigation for pheochromocytoma maybe needed.

Visit to a physician will be helpful for a detailed clinical examination.
Hope you found the answer helpful, please let me know if there's any further queries,
Regards
Dr Deepti Verma

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

Follow up: Dr. Deepti Verma (15 hours later)

Thank you for the answer doctor. I would like to know the following:

How frequently should I get my blood pressure checked??

Since the elevated blood pressure is not persistent, should I take any medications for it, when the blood pressure is high -SOS medication?? If yes, kindly suggest a medicine. Currently, I am taking Diligan 25 - is this the right drug?? Should I continue with it??

Should I get a abdomen and Pelvic USG done?

Answered by Dr. Deepti Verma (10 hours later)

Brief Answer:
Take steps as advised

Detailed Answer:
Hello,
You can get blood pressure measured atleast weekly.
In case you have your own home BP instrument measurements can be taken more frequently and at different times of a day.
Medication is required if the BP persists above 140/90.
No antihypertensive to be taken on sos basis. Clonazepam can be taken to reduce the anxiety related BP rise.
You can get an ultrasound abdomen for renal assessment.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepti Verma (15 hours later)

thank you for your response.

I have taken my bp today. It is 160/90 today. Last week it was 160/100. I have taken Diligan 25 infrequently during this period. I will continue checking my bp weekly.

Will get an ultrasound usg done for renal assesment.

You have mentioned that no SOS medication to be taken, but if my bp has been on the higher side since a week, still no medication to be taken?? You have not answered my query about Diligan 25. Is it right medication to take?? Or should I stop it and take clonazepam instead?? I don't think i will be able to purchase clonazepam without prescription.

Kindly respond on the issue of medication.

Thanks for your advice.

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
Measure Bp regularly and start medications in BP raised

Detailed Answer:
Hello,
If you are having persistent raised BP on two different occasions, you need to start antihypertensive drugs.
Diligan is for vertigo and cannot be taken for BP.
You can consult a physician with BP charting for medications.
You need to get a prescription for clonazepam.
Regards
Dr Deepti Verma
OBGYN specialist

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj