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What Causes Persistent High BP Despite Medication?
Question: Good Morning Dr. XXXXXXX XXXXXXX - I had shared the medical history of my elder sister with you and sought your help for controlling her high blood pressure. The following medicines were recommended by you:
1. Amlodipine 2.5 mg (added by you)
2. Betacap TR 40 (she was already taking in the morning)
3. Betacap TR 20 (she was already taking in the evening.)
Even after taking the above set of medicines, her blood pressure has remained high ranging between 155-170 & 90-100. Only on 2 occasions, blood pressure was low, i.e. 112-68 & 100-65 on 25th & 26th March 2017. Beside these 2 occasions, her blood pressure has been recorded high.
Please advise if any change is required in the medicines.
Regards...XXXX
1. Amlodipine 2.5 mg (added by you)
2. Betacap TR 40 (she was already taking in the morning)
3. Betacap TR 20 (she was already taking in the evening.)
Even after taking the above set of medicines, her blood pressure has remained high ranging between 155-170 & 90-100. Only on 2 occasions, blood pressure was low, i.e. 112-68 & 100-65 on 25th & 26th March 2017. Beside these 2 occasions, her blood pressure has been recorded high.
Please advise if any change is required in the medicines.
Regards...XXXX
Brief Answer:
I would like to advise few basic things
Detailed Answer:
Hello XXXXXXX
First of all I would like to thank you for showing your believe in me.
If the blood pressure is constantly staying elevated then I would like to increase the dose of Amlodipine to 5 mg instead of 2.5 mg along with regular bp monitoring. Make sure that she should be following healthy eating habits like low salt diet as I have mentioned before.
Continue Amlodipine 5mg for a week and then get back to me with Bp readings. If it still stay high then I would like to advise some test and would also think of changing her meds.
I would also like to know who has prescribed her betacap tr ?
Whether she is a diabetic or not ?
Does she have any kidney problem?
Kind Regards
Dr Bhanu partap
I would like to advise few basic things
Detailed Answer:
Hello XXXXXXX
First of all I would like to thank you for showing your believe in me.
If the blood pressure is constantly staying elevated then I would like to increase the dose of Amlodipine to 5 mg instead of 2.5 mg along with regular bp monitoring. Make sure that she should be following healthy eating habits like low salt diet as I have mentioned before.
Continue Amlodipine 5mg for a week and then get back to me with Bp readings. If it still stay high then I would like to advise some test and would also think of changing her meds.
I would also like to know who has prescribed her betacap tr ?
Whether she is a diabetic or not ?
Does she have any kidney problem?
Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by :
Dr. Kampana
Thanks Dr. XXXXXXX XXXXXXX Following are the answers to your queries:-
1. She is not a diabetic.
2. There is no problem with the Kidneys - 1 year back she had problem in passing
urine. We consulted RG Stones. They examined her fully and confirmed that
kidneys are ok. Problem was with the bladder. The problem is now 90% under
control with their medicines.
3. Since her BP was high at the time of examination, they only recommended
Betacap TR.
I just spoke to her after receipt of your mail. She informed that particularly when she goes to bed, she gets uneasiness and she has to put in efforts to breathe. At bed, she also gets heaviness in both the arms. She daily takes Alprax 0.5 mg at night to get sound sleep.
Shall proceed further with the medicine recommended by you (Amlodipine 5mg) once you revert.
Regards...XXXX
Further she has increased heart beat at most of the time of the day.
1. She is not a diabetic.
2. There is no problem with the Kidneys - 1 year back she had problem in passing
urine. We consulted RG Stones. They examined her fully and confirmed that
kidneys are ok. Problem was with the bladder. The problem is now 90% under
control with their medicines.
3. Since her BP was high at the time of examination, they only recommended
Betacap TR.
I just spoke to her after receipt of your mail. She informed that particularly when she goes to bed, she gets uneasiness and she has to put in efforts to breathe. At bed, she also gets heaviness in both the arms. She daily takes Alprax 0.5 mg at night to get sound sleep.
Shall proceed further with the medicine recommended by you (Amlodipine 5mg) once you revert.
Regards...XXXX
Further she has increased heart beat at most of the time of the day.
Brief Answer:
Thanks for the details
Detailed Answer:
Betacap Tr contains Propranalol which is a good drug for both rate and blood pressure control. Continue with amlodipine 5mg for a week then we will see what else need to be done.
I would also like to suggest you to get an ECG and if possible An ECHOCARDIOGRAPHY done and show me the reports.
Hope this will be helpful for her. I wish her Good Health.
Kind Regards
Dr Bhanu Partap
Thanks for the details
Detailed Answer:
Betacap Tr contains Propranalol which is a good drug for both rate and blood pressure control. Continue with amlodipine 5mg for a week then we will see what else need to be done.
I would also like to suggest you to get an ECG and if possible An ECHOCARDIOGRAPHY done and show me the reports.
Hope this will be helpful for her. I wish her Good Health.
Kind Regards
Dr Bhanu Partap
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Above answer was peer-reviewed by :
Dr. Kampana
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