Actually a combination of intravenous beta blockers and diltiazem (calcium channel blocker – CCB) is not good but oral beta blocker such as metoprolol and diltiazem can be used with regular monitoring of heart rate (pulse rate) and blood pressure. Both drugs decrease heart rate therefore it needs to be cautious while using both drugs concurrently. Metoprolol 50 mg twice daily is the normal dose of metoprolol. Advice 1. Continue metoprolol, diltiazem and hydrochlorothiazide as suggested by your doctor 2. Do not change dose or drug by yourself unless suggested by your doctor 3. Regular exercise at least 30 minutes for 5 days in a week. The best types of exercise for lowering BP include walking, jogging, cycling, swimming or dancing 4. Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products 5. Consume less salt 6. Avoid smoking, alcohol, coffee and caffeinated beverages 7. Lose extra weight if you are overweight and keep your body mass index between 19 and 25. BMI is calculated by formula BMI = Weight in Kilograms / (height in meters x height in meters) 8. Reduce your metal stress because stress activates sympathetic system and increases BP 9. Measure your BP regularly and be in touch with your doctor I hope this information will help you. I will be happy if you ask another question Thank