Brief Answer:
I would recommend as follows

Detailed Answer:

Hello,

Some blood pressure spikes occasionally are quite normal during anxiety or physical activity.

Anyway, you should know that even her actual blood pressure values are high.

For this reason, I would recommend increasing the dose of her antihypertensive drugs (losartan). What is the actual dose of losartan that she is taking?

Another option if her high blood pressure values persist, would be to add a calcium channel blocker (amlodipine, lercanidipine), in order to have a better management of high blood pressure.

I would also recommend performing some blood lab tests in order to exclude possible metabolic causes that may lead to high blood pressure:

- Blood electrolytes for possible imbalance
- Fasting glucose
- Thyroid hormone levels for possible thyroid gland dysfunction
- Kidney and liver function tests

You should discuss with her doctor on the above issues.

I remain at your disposal for any further questions whenever you need!
Regards,
Dr. Iliri

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