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How to manage hypertension effectively in senior citizens?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am a senior citizen woman. I am hypertensive but non-diabetic. Previously, I used to take Olmezest CH 20 (Olmesartan with Chlorthalidone) for blood pressure, along with Rozavel 5 (Rosuvastatin) and Esoz D 40 (Esomeprazole and Domperidone). I had been taking these medicines for a long time. I experienced some side effects with Olmezest CH 20. At one point, my uric acid level rose to 6.5, and I had leg pain. Additionally, my blood sugar levels were often borderline. Despite this, I continued taking Olmezest CH 20, and my blood pressure remained around 136/84 mmHg.

However, a few weeks ago, my blood pressure suddenly increased to 188/108 mmHg while I was still taking Olmezest CH 20. I became very worried and consulted a local doctor, who changed my blood pressure medication to Amlodipine 5 mg (Amlokind 5 mg). Since starting Amlokind 5 mg, my blood pressure has been around 140/90 mmHg.

For the past several weeks, I have been facing a peculiar health issue. I am unable to sleep properly at night. There have been many nights when I remained awake the entire night. Even if I fall asleep at around 11:30 PM, I wake up at 4:00 AM and cannot return to sleep. Many unusual thoughts come to my mind, making it difficult to sleep. This problem has been persistent.

For your information, when I was taking Olmezest CH 20, I rarely had sleep issues. My local doctor had prescribed Zapiz 0.25 mg (Clonazepam) for sleep, and it helped me sleep well. However, Zapiz 0.25 mg is no longer effective, and I continue to have difficulty sleeping.

  1. Could this be a side effect of Amlodipine?

  2. My last medical tests were performed several months ago. Do I need to undergo any additional tests now?

  3. Should I continue taking Rozavel 5 (Rosuvastatin) and Esoz D 40 along with Amlodipine?

Please help.

Thank you.

Answered by Dr. Wajahat

Education:

FCPS

Professional Bio:

Dr. Wajahat is an experienced Cardiologist dedicated to the prevention, diagnosis, and management of heart and vascular diseases. He specializes in treating hypertension, coronary artery disease, heart failure, and rhythm disorders. With a patient-centered and evidence-based approach, he focuses on accurate diagnosis, advanced cardiac care, and personalized treatment plans to improve heart health and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com

Thank you for sharing your health concern with us.

There can be several reasons for uncontrolled blood pressure that was previously controlled by medication. Common contributing factors include weight gain, excessive salt intake, poor sleep, pain anywhere in the body, medications that may interfere with blood pressure control, excessive consumption of alcohol, nicotine, or caffeine, and emotional stress. It is important to consider these possibilities and work toward correcting any relevant factors.

In general, the recommended blood pressure target is a maximum of 130/80 mm Hg. Your readings should ideally remain within this range. If your blood pressure remains elevated despite taking Amlokind 5 mg (Amlodipine), one possible approach may be to restart Olmezest CH 20 (Olmesartan with Chlorthalidone), along with appropriate lifestyle modifications. These measures include regular physical activity such as daily walking or exercise, relaxation techniques, yoga, reduction of dietary salt, the use of potassium-based salt substitutes when appropriate, and avoidance of preserved or pre-cooked foods that typically contain high amounts of sodium.

If additional blood pressure control is required, Amlokind 5 mg (Amlodipine) may be taken in the evening, while Olmezest CH 20 (Olmesartan and Chlorthalidone) is taken in the morning, provided this is advised by your treating physician.

There are no significant drug interactions between Rozavel (Rosuvastatin), Esoz D (Esomeprazole and Domperidone), Amlokind (Amlodipine), and Olmezest CH 20. Therefore, these medications can generally be continued together if they have been prescribed for you.

Regarding your sleep difficulty (insomnia), if Zapiz 0.25 mg (Clonazepam) is no longer effective, a temporary dose adjustment may sometimes be considered under medical supervision. Once sleep improves, the dose should be gradually reduced as advised by your doctor.

Your laboratory results appear largely within normal limits, with the exception of a mildly elevated uric acid level (hyperuricemia). Treatment is typically considered if levels rise significantly (for example, above 10 mg/dL) or if symptoms such as joint swelling or inflammation develop. Consultation with your primary healthcare provider is recommended for personalized guidance. Additionally, your echocardiogram (heart ultrasound) and electrocardiogram (ECG, heart rhythm test) do not indicate any major cardiovascular abnormalities.

Kindly revert if there are any queries.

Thank you.

Answered by Dr. Wajahat
Medically reviewed by iCliniq medical review team
Published At April 2, 2026
Reviewed At April 2, 2026

Education:

FCPS

Professional Bio:

Dr. Wajahat is an experienced Cardiologist dedicated to the prevention, diagnosis, and management of heart and vascular diseases. He specializes in treating hypertension, coronary artery disease, heart failure, and rhythm disorders. With a patient-centered and evidence-based approach, he focuses on accurate diagnosis, advanced cardiac care, and personalized treatment plans to improve heart health and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

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Education:

FCPS

Professional Bio:

Dr. Wajahat is an experienced Cardiologist dedicated to the prevention, diagnosis, and management of heart and vascular diseases. He specializes in treating hypertension, coronary artery disease, heart failure, and rhythm disorders. With a patient-centered and evidence-based approach, he focuses on accurate diagnosis, advanced cardiac care, and personalized treatment plans to improve heart health and overall quality of life.

This doctor is not available for online consultations on the platform anymore.

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