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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Elevated Blood Pressure Levels Be Treated?

hi my friend has just found out he has high blood pressure and was prescribed with hydochlorothiazide 25 mg once a day he starting getting constipation, muscle aches, and had no energy as well not being able to eat went back to the doctor and they changed the medication to metoprolol one of the side effects to this medication is depression he is all ready prone to depression what is a good blood pressure medication for him age 40.
Wed, 28 Feb 2018
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General & Family Physician,  's  Response
Hello,

Beta-blockers (metoprolol) can be a choice as a blood pressure reducing agent in younger patients with anxiety. However, guidelines suggest, not to use beta-blockers as a first choice unless specifically indicated. You are right, metoprolol like other beta-blockers cause depression and may augment depression in patients already suffering from it.

Anyhow I will recommend him starting Lisinopril once daily in the morning while stopping metoprolol. The full antihypertensive effect of many medications may take some weeks after starting them. After one week at least if the target blood pressure not achieved, he can gradually increase the dose to daily.


Hope I have answered your query. Let me know if I can assist you further.

Regards,  
Dr. Syed Hashim Ali Shah
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How Can Elevated Blood Pressure Levels Be Treated?

Hello, Beta-blockers (metoprolol) can be a choice as a blood pressure reducing agent in younger patients with anxiety. However, guidelines suggest, not to use beta-blockers as a first choice unless specifically indicated. You are right, metoprolol like other beta-blockers cause depression and may augment depression in patients already suffering from it. Anyhow I will recommend him starting Lisinopril once daily in the morning while stopping metoprolol. The full antihypertensive effect of many medications may take some weeks after starting them. After one week at least if the target blood pressure not achieved, he can gradually increase the dose to daily. Hope I have answered your query. Let me know if I can assist you further. Regards,   Dr. Syed Hashim Ali Shah