Brief Answer:
Most medicines do not cause decrease in blood pressure below normal

Detailed Answer:
Hi XXXXXXX
Thanks for writing in.

I have read through your query in detail.
Please find my observations below.

1. Blood pressure is the pressure of the flowing blood on the walls of blood vessels. It is a variable and does not stay constant.

2. Your blood pressure measures 109/ 69 mm Hg and is considered normal.

3. If the blood pressure is 90 mm Hg or less (systolic) or 60 mm Hg or less (diastolic) then it is considered to be low blood pressure.

4. Most medicines restore high blood pressure to normal and if the blood pressure is normal then it will not go below normal range. Please write in detail with the names of your blood pressure medicines so that we might discuss in detail.

5. It is important to continue medicine to control high blood pressure even if the blood pressure is normal and please do not discontinue without informing your doctor. However, should you experience symptoms like dizziness than please get in touch with your doctor.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
You might take Zestoretic and monitor blood pressure for next few days

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

1. Zestoretic contains a combination of hydrochlorothiazide (water pill) and lisinopril (ACE inhibitor which acts on the kidney). Dose of lisinopril in the range of 20 - 40 mg per day is safe.

2. Low blood pressure is usually seen in patients taking lisinopril having heart failure with systolic blood pressure below 100 mm Hg. Since your systolic blood pressure is 109 mm Hg therefore it is relatively safe for you to take the medication.

After taking Zestoretic take following precautions
(i) Please do not take alcohol
(ii) Do not take high potassium diet
(iii) Please do not gut up hurriedly from lying down or sitting position

3. Please monitor your blood pressure regularly in the mornings after 30 minutes of physical and mental relaxation and before taking the medicine. If it is on the lower range of normal then please discuss with your doctor.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Lisinopril is a relatively safe drug for blood pressure.

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

1. Lisinopril is a relatively safe medication to control blood pressure. Its mechanism of action is in the kidneys by which it reduces the blood pressure.

2. If your kidney function tests are normal then there is no need to panic. Long term side effects are rare and might involve the kidney and liver. Doing liver and kidney function tests regularly will help monitor any long term side effect.

3. Please get your potassium level checked regularly and follow up with your doctor every 3 - 6 months

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Normal blood potassium level is 3.5-5.1 mEq/L or mmol/L

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

1. Potassium is an electrolyte and should be maintained in a normal range for proper functioning of the cells. Lisinopril is known to cause increased potassium levels in blood. The normal potassium range in blood is 3.5-5.1 mEq/L or mmol/L

Eating certain foods might increase the blood potassium levels and therefore foods like bananas, beets, dried beans, green leafy vegetables, lentils, milk, oranges, peanuts and yogurt might be taken in moderate amounts and blood potassium levels checked regularly.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Eat low potassium foods and avoid too much high potassium foods

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

I want to make a clarification please

1. Please note that these foods mentioned earlier (like bananas, beets, dried beans, green leafy vegetables, lentils, milk, oranges, peanuts and yogurt) should be taken in mild to moderate amount and with care. The foods can cause high potassium if taken too much at a time.


2. Low potassium foods include and you can eat these in good amounts regularly
Apples, Blackberries, Blueberries, Cabbage, Carrots, Cauliflower, Corn, Cranberries, Cucumber, Eggplant, Grapes, Green beans, Lemon, Lettuce, Lime
Mushrooms, Onions, Pineapple, Plums, Radishes, Raspberries, Strawberries, Tangerines, Watermelon

3. To some extent high blood pressure can be controlled by eating low salt diet and this has benefited many patients. The control depends on your blood pressure level.

Warm sensation on your right foot requires detailed evaluation if it is happening regularly. It is not a specific symptoms of a particular condition and might be seen in many conditions. However, please get your blood potassium level checked.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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