Should my wife continue Cilacar if her BP remains high?

Question

Hello doctor,

I seek your medical advice regarding my wife's hypertension. She is 70 years old and diabetic. Her Hb A1c is always below 6. She used to have mild BP before a few years, and her systolic reading was 140 to150 and diastolic 80 but not higher readings in both. Our physician at that time prescribed Stamlo 5 mg (Amlodipine) once a day. Since then, her readings have come down to 120/80. She is taking this until last year. Her readings were always normal. She consulted the physician last year for swellings in her feet. He has asked her to discontinue Stamlo 5 mg and prescribed 10 mg Cilacar (Cilnidipine). Ever since she is taking this, her swellings disappeared. After a month, I have monitored her BP for four or five days since her drug is changed after 23 years and again in this month. Please see the table of readings enclosed.

I found the readings are almost the same the following month. She has hyperthyroidism for the past seven years. She is asymptomatic and no problem with that. She has no tensions or worries and takes the medicines very punctually. She has no other symptoms regarding heart, like palpitations, rapid heart rate, etc.

My question is, whether the readings are not a matter of concern, and can she continue with the same medicine and dosage? Or whether she should add or change with another safe drug?

Her current medications are Glycomet 500 mg twice daily, Cilacar 10 mg once, Thyronorm once, and Ecosprin AV 75 once daily. Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

Her sugar readings are fine, so she should continue with the same. However, her BP readings are elevated. Our target blood pressure is systolic 110 to 130, and even 130-140 is fine but less desirable. And diastolic anything less than 90 mmHg, does not matter how much low it is.

And BP readings change from time to time, season to season, according to weight, diet, etc. So dose or drug might need to be changed from time to time.

Now, in my opinion, you should add 5 mg of Cilnidipine in the evening (if taking 10 mg in the morning or vice versa). If, despite adding 5 mg, BP remains more than 130 mmHg, make it 10 mg twice daily, considering that the lowest systolic reading is not less than 110 mmHg. At present, no need to add any other medications.

So keep monitoring BP three times a day for a week. At a time, take three BP readings, and two matching readings out of three are approximate BP. The arm should be rested on the table and being completely relaxed during readings.

I hope this helps.