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What Causes Hypertension In An Elderly Person While On Nifedipine And Metoprolol?

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Posted on Fri, 2 Jun 2017
Question: Mom is 92. She recently began having increased blood pressure...170/55 heartrate is 59...
Having signs of XXXXXXX stroke-- tia---slurring of words and incomplete sentences...cant say thoughts...for 1 hour...then resolved
one arm weak heavy ... one or 2 hours...separate days
Afib for 3 instances on 3 different days... for 2 hour increments... resolved
Her meds are--- daily.... for last week
Plavix
Nifedipine 90mg
Multaq 800 mg
Hctz 25 mg
Metoprolol... increased from 50 mg to 100 mg
Today she was really weak and overly sleepy... would the metoprolol increase make her weak?? We dont know if some of the meds cause weakness or sleepy. Please assess her meds for making her sleep so muchvv


doctor
Answered by Dr. Rishu Saxena (28 minutes later)
Brief Answer:
Additive effect of medicines she is on.

Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query.
I am Dr Rishu a cardiologist and would be answering your query.

Severe weekness and fatigue is a side effect of dronedrone(Multaq).
Hctz is a diuretic.It causes the body to loose electrolytes like sodium and potassium.Loss of these electrolytes from body can also be responsible for fatigue and weekness.Get a serum electrolyte done.

Metoprolol is a betablocker which again has a side effect of causing fatigue and lassitude.

So her excessive fatigue and sleepiness is a result of additive action of the drugs she is on.

Don't worry in a few days body would start adapting to these medicines and these side effects would vanish.

Hope i answered your query well.
Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Rishu Saxena (5 hours later)
Dr her blood pressure has for a long time has had the systolic run high... about 150 and the diastolic runs low.. about 50-55.... heart rate is low also....about 55-65..... of course these recent med changes were a result of the TIA symptoms she had within the last 2 weeks as stated before and blood pressure running high also. Do you feel that the lower heart rate makes her fatigued? Is it dangerous for her to have such a low heartrate??
doctor
Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
Follow up.

Detailed Answer:
Hi again Dear,
At a age of 92 heart rate 55-65 will not be considered as lower considering the fact that patient is on high dose metoprolol along with antiarrythmic. We can say that its marginally on lower side but i don't think it is responsible for her weekness or fatigue.
See the patient is on Multaq 800 mg its an anti arrythmic and usually lowers heart rate in patient.
At a age of 92 a heart rate lower then 50 should be alarming however if its in between 55-65/minute i don't feel that there is a need to worry. she is also on high dose of beta blockers which also decreases heart rate.So just keep a watch that heart rate should not go below 50/minutes.


Hope i answered your query well,Follow ups are welcome.

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

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Causes Hypertension In An Elderly Person While On Nifedipine And Metoprolol?

Brief Answer: Additive effect of medicines she is on. Detailed Answer: Hello, Thanks for choosing HealthcareMagic for your query. I am Dr Rishu a cardiologist and would be answering your query. Severe weekness and fatigue is a side effect of dronedrone(Multaq). Hctz is a diuretic.It causes the body to loose electrolytes like sodium and potassium.Loss of these electrolytes from body can also be responsible for fatigue and weekness.Get a serum electrolyte done. Metoprolol is a betablocker which again has a side effect of causing fatigue and lassitude. So her excessive fatigue and sleepiness is a result of additive action of the drugs she is on. Don't worry in a few days body would start adapting to these medicines and these side effects would vanish. Hope i answered your query well. Thanks.