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What Causes Fluctuations In BP?
Question: I am taking temisartan CT 80mg plus concor 2.5mg at morning and amlodipine 5 mg during evening. After about one hr of morning walk and 20Minutes of Muscle stretch the BP falls to 110 / 75 which gradually increases to sometime 160/90 sometimes prior to taking amplodipine in evening . Heart rate always is about 60 . All tests reveals parameters are normal with 6mg/dl uric acid for which I take Febuget 20mg. I am 58 . Pl advise.
Brief Answer:
The fluctuations are still in normal range and may not be actively pursued
Detailed Answer:
Hello, Mr XXXX, I am Dr Mody and I would be helping you with the concern you share.
Firstly I would like to assure you that all the parameter you have described is perfectly under normal range with borderline shoots which we can manage with titration.
1)pulse on 60 is because of concor, and I would like to assure you that 60 pulse rate highly desirable for a longer and healthy life and you achieving it partly because of concern and some part because of the exercise schedule.
2) as I said post exercise the lower pressure would always go low, it is because the resistance from the peripheral muscle which is the reason for diastolic pressure would decrease so exercising muscle get enough blood to prevent fatigue during training. It's a natural phenomenon.
No worries onto that.
3) now the CT component of telmisartan is a diuretic and it's flushes along with extra water electrolytes. At the same time exercise would result in some sweat which would result in some loss of electrolytes. Leading to decreased upper pressure.
Again I would assure you that it's still in the normal range, lastly the increase Might be body's way of correcting the pressure fluctuations . However if transient, Not to worry for same.
So my recommendation are.
1) take some electrolyte, may take glatorade on the day when you are going to undergo good workout
2) continue febustat for the uric acid which is in normal range, though we may titer it down
3)the fluctuation of 160/90 just before the next antihypertensive is something we may need to do
However when you are on long term regime your body is used to it and change which by all means is a calculated trial and error, may result in more fluctuations. One small thing we can consider if this fluctuations increase ( as I consider 160/90 still just borderline if transient), is instead of taking telmisartan CT in morning as a combination, you can take separate telmisartan in morning and Chlorthalidone (CT) before lunch, post workout. I hope you understand the logic.
Hoping I could help, sending all reports and more medical history I would be able to help in a more objective way
Regards Dr Priyank Mody, Lilavati Hospital, XXXXXXX
The fluctuations are still in normal range and may not be actively pursued
Detailed Answer:
Hello, Mr XXXX, I am Dr Mody and I would be helping you with the concern you share.
Firstly I would like to assure you that all the parameter you have described is perfectly under normal range with borderline shoots which we can manage with titration.
1)pulse on 60 is because of concor, and I would like to assure you that 60 pulse rate highly desirable for a longer and healthy life and you achieving it partly because of concern and some part because of the exercise schedule.
2) as I said post exercise the lower pressure would always go low, it is because the resistance from the peripheral muscle which is the reason for diastolic pressure would decrease so exercising muscle get enough blood to prevent fatigue during training. It's a natural phenomenon.
No worries onto that.
3) now the CT component of telmisartan is a diuretic and it's flushes along with extra water electrolytes. At the same time exercise would result in some sweat which would result in some loss of electrolytes. Leading to decreased upper pressure.
Again I would assure you that it's still in the normal range, lastly the increase Might be body's way of correcting the pressure fluctuations . However if transient, Not to worry for same.
So my recommendation are.
1) take some electrolyte, may take glatorade on the day when you are going to undergo good workout
2) continue febustat for the uric acid which is in normal range, though we may titer it down
3)the fluctuation of 160/90 just before the next antihypertensive is something we may need to do
However when you are on long term regime your body is used to it and change which by all means is a calculated trial and error, may result in more fluctuations. One small thing we can consider if this fluctuations increase ( as I consider 160/90 still just borderline if transient), is instead of taking telmisartan CT in morning as a combination, you can take separate telmisartan in morning and Chlorthalidone (CT) before lunch, post workout. I hope you understand the logic.
Hoping I could help, sending all reports and more medical history I would be able to help in a more objective way
Regards Dr Priyank Mody, Lilavati Hospital, XXXXXXX
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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