Hello doctor, My mother is 76 years old. She is diabetic and has high BP. She takes Co-Diovan 160/12.5 in the morning, Bisoprolol 10 mg on lunch and Lekarnidipine 10 mg in the evening but the BP yet is not stabilized. What should be done?
Hi. What is your mother's BP on these medicines? Your mother is taking multiple medicines to control BP, still, BP is not under control, the cause may be due to secondary hypertension. The most common cause is kidney disease. Is there any history of heart disease or stroke? For proper BP control follow these guidelines. Avoid junk and fatty foods, reduce salt intake in the diet. Maintain a healthy weight, BMI should be less than 25. Measure BP at home, with the patient seated and backrest, the cuff should be at the heart's level and arm resting on the table. The patient should be relaxed for 15 minutes. Then measure BP. Repeat BP check in other arm. Remeasure BP in the arm with higher BP after 10 minutes. Lower of the two readings is the patient's BP. Take medicines at same times daily, take sound sleep. Regarding BP control, I would recommend to have renal function tests and electrolytes done and ultrasound of kidneys. These reports may change medicines or doses for hypertension. I recommend tablet Amlodipine, Valsartan, HCT 10/160/12.5 daily in the day time. Measure daily BP at random times and note it for 10 days. Continue Bisoprolol. No need for Aldomet. After 10 days, we will see how much BP is controlled and what is the BP trend. Then will decide further about management. Continue Insulin, keep blood sugar levels under control. Non or poor compliance to medicines, inappropriate doses, renal disease. Urea, creatinine, electrolytes, ultrasound of kidneys for size and parenchymal changes. Reduce salt intake, avoid junk, fast food, fatty foods, avoid alcohol, smoking.