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What Causes High Blood Pressure And Pitting Edema In The Feet?
Question: My mother 73 yrs oldwas hospitalized last week in the ICU for 3 days as she had hyponatremia, Sodium was 105 on admission.
She has hence improved and is home, her bp is kind of high from yesterday she was on Amlong 2.5 mg daily, it was stopped while in hospital as her bp was always normal readings.
now the reading is 156/114 and last night it was 160/100 gave her one 2.5 mg amlong 2.5 at night, should i give her another dose this morning? she also has pitting odema of feet, never had this before.
She has hence improved and is home, her bp is kind of high from yesterday she was on Amlong 2.5 mg daily, it was stopped while in hospital as her bp was always normal readings.
now the reading is 156/114 and last night it was 160/100 gave her one 2.5 mg amlong 2.5 at night, should i give her another dose this morning? she also has pitting odema of feet, never had this before.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that blood pressure and sodium levels are closely related. Increasing salt intake leads to increased blood pressure values.
This may explain why she has high blood pressure now that her sodium levels are higher.
From the other hand amlong 2.5mg is an antihypertensive drug of calcium channel blocker class. But, it may cause leg swelling as an adverse effect. Anyway this is a really low dose.
Coming to this point, I recommend consulting with her attending physician and discussing the possibility of switching to another antihypertensive drug like ARB (valsartan, telmisartan) or an ACEI (lisinopril, enalapril) in order to have a better control of high blood pressure.
I would not recommend any further raise in the daily dose of amlong as long as she has pitting edema in her legs (which could be aggravated by this drug).
If the pitting edema persists, despite blood pressure lowering and amlong interruption, I would recommend performing further tests to investigate for the possible underlying causes:
- a cardiac ultrasound to examine her heart and exclude heart failure
- kidney and liver function tests
- blood electrolytes
- an urine analysis.
You should discuss with her doctor on the above issues.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would explain that blood pressure and sodium levels are closely related. Increasing salt intake leads to increased blood pressure values.
This may explain why she has high blood pressure now that her sodium levels are higher.
From the other hand amlong 2.5mg is an antihypertensive drug of calcium channel blocker class. But, it may cause leg swelling as an adverse effect. Anyway this is a really low dose.
Coming to this point, I recommend consulting with her attending physician and discussing the possibility of switching to another antihypertensive drug like ARB (valsartan, telmisartan) or an ACEI (lisinopril, enalapril) in order to have a better control of high blood pressure.
I would not recommend any further raise in the daily dose of amlong as long as she has pitting edema in her legs (which could be aggravated by this drug).
If the pitting edema persists, despite blood pressure lowering and amlong interruption, I would recommend performing further tests to investigate for the possible underlying causes:
- a cardiac ultrasound to examine her heart and exclude heart failure
- kidney and liver function tests
- blood electrolytes
- an urine analysis.
You should discuss with her doctor on the above issues.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The sodium level was 129 two days ago, nacl tablets have been stopped. Pitting oedema persists. Amlong no change in dose. Family physician back in home country XXXXXXX Patient travelling back in a week from Canada. Any precautions to be taken before the long travel??
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
129 is a low level. I would recommend increasing salt intake, although her blood pressure is high.
As she has been in the ICU unit, they may performed further tests to investigate for the possible causes.
Heart failure or diabetes could also be the cause of low sodium levels and pitting edema.
Did she perform a cardiac ultrasound during her hospitalization? I would be happy to review her echo report for another professional opinion.
I would also recommend adding a diuretic to her therapy, like furasemide. A daily dose of 60mg , would help normalize her blood pressure and would also improve her pitting edema.
Hope to have been helpful!
Best wishes,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
129 is a low level. I would recommend increasing salt intake, although her blood pressure is high.
As she has been in the ICU unit, they may performed further tests to investigate for the possible causes.
Heart failure or diabetes could also be the cause of low sodium levels and pitting edema.
Did she perform a cardiac ultrasound during her hospitalization? I would be happy to review her echo report for another professional opinion.
I would also recommend adding a diuretic to her therapy, like furasemide. A daily dose of 60mg , would help normalize her blood pressure and would also improve her pitting edema.
Hope to have been helpful!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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