Q. What is the significance of a fluctuating blood pressure?
Hello doctor,
My father has been suffering from hypertension for more than 12 years and has been taking medication. For the past six to seven months, his blood pressure has been very much under control with ayurvedic treatment. So, he very gradually decreased and stopped taking the medicines. Around four to five weeks back, his blood pressure started rising again. So, he restarted some medications after consultation with the doctor. Now, we are seeing fluctuations in his daily blood pressure varying from (systolic readings) of 115 - 170 mmHg during the day (his systolic blood pressure reading even dropped to 95 mmHg after taking one of the tablets - Prazopress, after which the doctor asked to take that specific tablet - Prazopress on a requirement basis). We have done all the relevant tests, which seem fine according to our doctor, except for high cholesterol and Vitamin-D deficiency. He is currently taking Nebicard, Clopitorva, Olmax, and sometimes Prazopress when his blood pressure shoots over 170 mmHg. He also takes appropriate precautions with food and goes for morning and evening walks for 30 minutes each. What is the significance of this fluctuating blood pressure? Are there any risks involved? Do we need to change the medication?
Hi,
Welcome to icliniq.com. I have read your query, and I have seen the reports (attachment removed to protect patient identity). Firstly, I think that the Atorvastatin dose you are getting may be too low. A dose of 20 mg may be needed at the least, and Clopitorva (Atorvastatin plus Clopidogrel) has only 10 mg. So, I think you need to change it. Secondly, I think I would suggest a Vitamin D replacement. A Calcerol (Cholecalciferol) sachet of 60000 units once a week with a glass of milk should help. Take this for six weeks. Then repeat Vitamin D for seven weeks. Take it on the same day every week. I think Olmesartan that you are taking is a good choice. But the dose may not be sufficient. Since you have not mentioned the dose in the query, I cannot comment on it. Also, considering the fluctuations, I would recommend two doses of Telmisartan instead. This may help keep the blood pressure uniformly stable. Also, he is on too many anti-hypertensives. I usually recommend giving anyone and then stepping up slowly. Personally, I do not understand the query why Clopivas is being given. A blood thinner is usually given to a patient with heart disease or stroke. So, this point you may discuss with the good doctor who initiated the medicine. This is the same for Nebicard. I would suggest testing for kidney function. Consult a specialist doctor, discuss with them, and take medications with their consent. I hope this information helps.
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