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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Uncontrollable High BP Readings

My mom is taking Losartan 50mg and Metropolol 50mg daily. She is diabetic, no heart condition, she has glaucoma and diabetic retinopathy. After taking the BP meds, instead of going down, it increases. Should she be switched to a different class of BP medication? Thanks in advance
Wed, 24 Dec 2014
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Internal Medicine Specialist,  's  Response
Hello welcome to HCM.
I have read your question and understand your concerns.

Actually metoprolol and losartan is not a good combination unless you have a heart related issues like heart failure or previous heart attack.

Longterm target for blood pressure at any age shop be less than 140/90 mmhg.

So, my advice to you is ask your doctor to gradually reduce metoprolol dosage and switched to calcium channel blockers (like amlodipine or cilacar). If necessary 3 drugs also can be given simultaneously.

Do 24 hrs ambulatory blood pressure monitoring which will give definitive idea regarding blood pressure fluctuations. According to that report your doctor can adjust the dosage of medications.

Do Renal doppler study, early morning serum cortisol levels, serum free metanephrine levels if still blood pressure remains elevated to rule out resistant hypertension(your doctor will understand this if you ask him)

Thank you.
Have a nice day.
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Suggest Treatment For Uncontrollable High BP Readings

Hello welcome to HCM. I have read your question and understand your concerns. Actually metoprolol and losartan is not a good combination unless you have a heart related issues like heart failure or previous heart attack. Longterm target for blood pressure at any age shop be less than 140/90 mmhg. So, my advice to you is ask your doctor to gradually reduce metoprolol dosage and switched to calcium channel blockers (like amlodipine or cilacar). If necessary 3 drugs also can be given simultaneously. Do 24 hrs ambulatory blood pressure monitoring which will give definitive idea regarding blood pressure fluctuations. According to that report your doctor can adjust the dosage of medications. Do Renal doppler study, early morning serum cortisol levels, serum free metanephrine levels if still blood pressure remains elevated to rule out resistant hypertension(your doctor will understand this if you ask him) Thank you. Have a nice day.