Hello doctor, My father has been suffering from hypertension for more than 12 years and has been taking medication. For the past six to seven months, his blood pressure has been very much under control with Ayurvedic treatment. So, he very gradually decreased and stopped taking the medicines. Around four to five weeks back, his blood pressure started rising again. So, he re-started some medications after consultation with the doctor. Now, we are seeing fluctuations in his daily blood pressure varying from (systolic readings) 115 - 170 during a day (his systolic blood pressure reading even dropped to 95 after taking one of the tablets - Prazopress, after which doctor asked to take that specific tablet - Prazopress on requirement basis). We have had all the relevant tests, which look fine as per our doctor, except for high cholesterol and Vitamin-D deficiency. He is currently taking Nebicard, Clopitorva, Olmax and sometimes Prazopress when his blood pressure shoots over 170. He also takes appropriate precautions with food and goes for morning and evening walks each for 30 minutes. What is the significance of this fluctuating blood pressure? Are there any risks involved? Do we need to change the medication?
Hi. I have read your query, and I have seen the reports (attachment removed to protect patient identity). Firstly, I think that the Atorvastatin dose you are getting may be too low. A dose of 20 mg may be needed at the least, and Clopitorva (Atorvastatin plus Clopidogrel) has only 10 mg. So, I think you need to change it. Secondly, I think I would suggest the vitamin D replacement. A Calcerol (Cholecalciferol) sachet of 60000 units once in a week with a glass of milk should help. Take this for six weeks. Then repeat Vitamin D for seven weeks. Take it on the same day every week. I think Olmesartan that you are getting is a good choice. But the dose may not be sufficient. Since you have not mentioned the dose in the query, I cannot comment on it. Also, considering the fluctuations, I would recommend two doses of Telmisartan instead. This may help keep the blood pressure uniformly stable. Also, he is on too many anti-hypertensives. I usually recommend giving any one and then step up slowly. Personally, I do not understand the query why Clopivas is being given. A blood thinner is usually given in a patient of heart disease or stroke. So, this point you may discuss with the good doctor who initiated the medicine. This is same for Nebicard. I would suggest testing kidney function. I hope this information helps. For more information consult an internal medicine physician online -->