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Suggest Medications For A 61 Year Old Lady Diagonosed With Hypertension And Diabetics
My mother (61yr, height-150cm, weight-65.5kg) was diagnosed to have hypertension in 2003 and pre-diabetes last year. She is taking atenolol 50mg, amlodipine 10mg and simvastatin 20mg until now. When i do everyday blood pressure check at home her BP always below 110/70, pulse below 75 and sometimes fall to below 50. She felt unenergetic and headache. But when she had a checkup at a clinic her BP raised about 175/85, pulse 100+. Her blood glucose was 9.7 and a doctor asked her to take care of the diet. However, today even her blood glucoce is still 9.7, the doctor prescribed metformine 500mg. My questions, does atenolol contribute to very low pulse rate and do she need to continue taking it or change to other medicine? Second, is it necessary for her to start medication for her diabetes even blood glucose level maintain 9.7 or better just to watch her diet? Thank you=)
Wed, 9 Jul 2014
Dear Sir/Madam,
The B.P raise in the clinic might have been because of what we call as "White coat Hypertension" or in simple words anxiety in the clinic. The Blood sugars are slightly elevated. For diagnosis in India we use 200mg/dl as a bench mark when testing random blood sugar. (1 mmol = 18mg/dl)
My humble opinion
Do a glucose tolerance test to decide on the state of diabetes.
Beta blockers are known to cause bradycardia plus as her sugars are marginally high its better to avoid atenolol. Generally we do not prescribe atenolol in patients who show tendency of developing diabetes.
Hope i have cleared all your doubts.
The B.P raise in the clinic might have been because of what we call as "White coat Hypertension" or in simple words anxiety in the clinic. The Blood sugars are slightly elevated. For diagnosis in India we use 200mg/dl as a bench mark when testing random blood sugar. (1 mmol = 18mg/dl)
My humble opinion
Do a glucose tolerance test to decide on the state of diabetes.
Beta blockers are known to cause bradycardia plus as her sugars are marginally high its better to avoid atenolol. Generally we do not prescribe atenolol in patients who show tendency of developing diabetes.
Hope i have cleared all your doubts.
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