Q. How to lower high blood pressure in a 60-year-old?

Answered by Dr. Nagaraj and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 19, 2023 and last reviewed on: Dec 13, 2023

Hello doctor,

This query is for my father-in-law, who is a 60-year-old and has high blood pressure. In winter, he always has a blood pressure reading on the higher side and has been taking blood pressure medicines daily for the last few years. These days, his blood pressure is regularly in the range of 150/90 mmHg, and it sometimes lowers and gets up, like today it was 170/90 mmHg. He is taking medicines which are as follows-

Tablet Triolmezest 40.

Tablet Cilacar.

Tablet Ecosprin.

Tablet Etizola Beta.

This can be cross-checked by the prescription attached. No major symptoms are being felt by him, like headache or any other symptoms, and he is feeling fine. The ECG was also done, and from our understanding, the report is normal. The only concern is why the blood pressure is not lowering when the medicines are taken. Kindly suggest.

MBBS., MD PHARMACOLOGY., MRCP (UK
Diabetology General Medicine Internal Medicine

Hello,

Welcome to icliniq.com.

I can understand your concerns. I have seen the attached prescription (attachment removed to protect the patient's identity). Your father-in-law is taking three medicines as a combination at one time and one tablet for high blood pressure at another time. Although he has no symptoms, there is scope for better control of his blood pressure. I am not sure when he has high blood pressure. When were the medicines started? Was there any change in the medicines or any new medicine added recently? It is mentioned tablet Thyrox. Is he taking this medicine? If yes, since when? Kindly let me know so I can suggest better.

Thank you.

Hello doctor,

He has been taking blood pressure medicines for the last ten years and the tablet Thyrox for the last eight years. Some years back, he had thyroid, and since then, he has been taking thyroid medicines. For the blood pressure, earlier, he was taking a different medicine: Tazloc trio (Telmisartan and hydrochlorothiazide). He was taking this medicine daily at night. Recently the blood pressure again spiked this month, then he himself started taking the tablet Tazloc two times a day. Afterward, he went to see the doctor, discontinued the tablet Tazloc and was prescribed new medicines. He has sometimes experienced pain in the right side of the shoulder. I have searched for the name of the bone on the internet, and maybe the name of that bone is the clavicle. But the pain is not in the muscle, it is experienced in the bone of the shoulder. Kindly suggest.

MBBS., MD PHARMACOLOGY., MRCP (UK
Diabetology General Medicine Internal Medicine

Hello,

Welcome back to icliniq.com.

I suggest dose modifications are required. He is taking three different medications at low doses. Instead, one of the doses of the medication can be increased until his blood pressure comes under control. Sometimes the problem with multiple medications in one drug cannot help us know which is working and which component is not. Your doctor can do this by slowly titrating the medicines. Also, note that blood pressure is not constant all the time. There are variations in its reading which is normal. Digital blood pressure monitors used at home are not accurate. I suggest you check your blood pressure in the clinic or hospital using a mercury manometer. In some people, blood pressure increases in clinics or hospitals, which we call white coat hypertension. Leaving all this aside, please speak to your doctor about the issue. I am sure he will titrate the medications. Age of 60, with no other medical conditions, the blood pressure can be easily brought under control. Do not forget the role of regular exercise. Please ask him to exercise regularly or walk, as this will help control high blood pressure and overall health. Also, no added salt in food (like pickles, etc.). I hope this helps.

Thank you.


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