<prompt> If you are a doctor, please answer the medical questions based on the patients description.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 150100 , 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 13090. The BP now starts increasing around 4-00 pm . The measurement at this time is 14590. Another 2 hours before I can take TELMA 20. For the time I have started TELMA the BP is fluctuating . Please advise. Rajeev Srivastava  <response>: Hello and thank you for using Chat Doctor. 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 physicals trees so Its mandatory to judge on mean values. If you have mean values above 13090 than we should make some changes in your therapy. The rises during afternoon is a sign that the blood pressure is not controlled under this current dosages. You have good medications, and you are under small dosage. It is possible to rise the both dosage Oslo up to 10 mg and Selma 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 Selma up to 40 mg at noon. If we still dont have results than we can rise the dosage of Oslo up to 10 mg. After this changes you have to monitor your blood pressure values with a holder monitoring or by your self twice a day. Hope I was helpful. Best regards, 