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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Elevated Diastolic BP

3 years after aortic valve replacement (mechanical, MICS, to correct severe aortic stenosis, with little to no problems in other veins arteries, when I was 58 [now about to turn 62]), my diastolic bp is too high. Sometimes 150-155/67-77. Better (normal) for me is 145/70 (+/- 2 points either way on both readings). My best readings will be in the mid 130s/high 60s. Thought the higher diastolic was due to the wall thickening that developed during the stenosis. Cardiologist says that s not the case and wants to take me off of altace (rose dose from 2.5 mg to 20 mg, 9+ years ago as the systolic began to rise due to the then moderate stenosis, which became severe and eventually required valve replacement). Thought the high systolic was due to the heart wall thickening, which I believe does not go back to normal. Last 9 months or so, getting much better diabetic control due to use of Victoza (Hb1 down from high sevens to low sixes, maybe even fives since my last Hb1 draw some 4 months ago. Endocrinologist now wants a FBS draw every 6 months instead of previous 3). After valve replacement, lost 20 lbs then back up 10, since Victoza began, down twenty from the intermediate level (so down 30 since pre cardiac surgery). 252 232 242 222. Height 5 9 . Due to AB+ blood, warfarin dose is high (17.5 for a rare blood type that has unusual thickness [studies show the AB factor is 30% more likely to strok than general population]). Am concerned that valsartan may not help my (currently) well-controlled diabetes, and some patients, in reviews are questioning the efficatiousness of valsartan in controlling bp, and its interactions with sugar levels (raising their Hb1 between 0.7 and 1.1). Any thoughts, pros and cons, interactions espeially with warfarin & Victoza, and my diabetes, especially (but also any heart issues)?
Fri, 27 Jul 2018
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Dermatologist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Valsartan is fine. You should it. It will help you in preventing kidney problems because of diabetes and also it will help with your heart disease and also is for increased blood pressure.

Hope I have answered your query. Let me know if I can assist you further.
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Suggest Treatment For Elevated Diastolic BP

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Valsartan is fine. You should it. It will help you in preventing kidney problems because of diabetes and also it will help with your heart disease and also is for increased blood pressure. Hope I have answered your query. Let me know if I can assist you further.