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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Increasing BP In The Evenings

Hello Doctor,

I am 62 years old male in New Delhi.I have been having ESLO 2.5 mg every morning for the past 5 years.This winter when my BP touched 150/100 , I have been prescribed ESLO 5.0 mg in the morning (9-00 Hrs) and TELMA 20 at 6-00 pm in the evening. My blood pressure has not gone below 130/90. The BP now starts increasing around 4-00 pm . The measurement at this time is 145/90. Another 2 hours before I can take TELMA 20. For the time I have started TELMA the BP is fluctuating . Please advise.



Rajeev Srivastava
Fri, 15 Apr 2016
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Cardiologist,  's  Response
Hello and thank you for using HCM.I carefully read your question and I understand your concern.
I will try to explain and give you my opinion.

You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values.

If you have mean values above 130/90 than we should make some changes in your therapy.
The rises during afternoon is a sign that the blood preasure is not controlled under this current dosages.

You have good medications and you are under small dosage.It is posible to rise the both dosage eslo up to 10 mg and telma up to 40 mg.

So, if I was your treating doctor I will rise the dosage of one of this medication, like the dosage of telma up to 40 mg at noon.
If we still dont have results than we can rise the dosage of eslo up to 10 mg.

After this changes you have to monitor your blood pressure values whith a holter monitoring or by your self twice a day.

Hope I was helpfull.
Best regards, Dr. Ervina.
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What Causes Increasing BP In The Evenings

Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain and give you my opinion. You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values. If you have mean values above 130/90 than we should make some changes in your therapy. The rises during afternoon is a sign that the blood preasure is not controlled under this current dosages. You have good medications and you are under small dosage.It is posible to rise the both dosage eslo up to 10 mg and telma up to 40 mg. So, if I was your treating doctor I will rise the dosage of one of this medication, like the dosage of telma up to 40 mg at noon. If we still dont have results than we can rise the dosage of eslo up to 10 mg. After this changes you have to monitor your blood pressure values whith a holter monitoring or by your self twice a day. Hope I was helpfull. Best regards, Dr. Ervina.