Is fluctuating blood pressure due to anxiety concerning?

Question

Hello doctor,

This query is regarding my father. He is 65 years old and hypertensive for the last 15 years. He was on Ramistar 5 mg and Amlodipine 2.5 mg and one diuretic. Recently, his doctor increased his dose to Ramistar 10 mg and Amlodipine 5 mg. I am an MBBS doctor and I check his BP twice daily. His systolic by palpatory is quite low around 120 mmHg, but on auscultation, it is 140 to 150 mmHg with diastolic 90 mmHg. I do not understand the difference.

He is an anxious person and gets very anxious while measuring BP. I take three to four times and it starts with high, but eventually settles to the BP mentioned above. Also, he has BPH and takes Alfusin D. Will this drug decrease the efficiency of BP medicines? I want to add that he had his stress thallium test 15 days back, which came back normal.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

Variation of systolic blood pressure in a palpatory and auscultatory method is usually plus or minus 10 mmHg. To the readings of palpatory usually 10 mmHg is added to get an auscultatory blood pressure. So, please make sure that your apparatus is accurate and that the person taking blood pressure is well-versed in it.

Alfuzosin and Dutasteride is meant for treating benign hypertrophy of the prostate and has no documented interactions with the medicines your father is taking for blood pressure. Stress thallium is normal as told you earlier. Please get your BP apparatus checked and make sure BP is auscultated by a trained person.

I hope this helps.

Thank you.