How to manage high blood pressure?

Question

Hello doctor,

I am posting this query on behalf of my mum. She was diagnosed with high blood pressure three years ago and was prescribed medication by her doctor. However, the problem is that she cannot sleep at night when she is on the medication. As a result, she sometimes has to stop taking it for five to six days, which makes her blood pressure very inconsistent. The medicine she takes is called Nifedipine 20 mg. Could you kindly advise on a suitable medication that would help control her blood pressure and also allow her to sleep at night?

Answer 1

Hello,

Welcome to icliniq.com.

She should be started on Telmisartan 20 mg once daily in the morning, with the option to increase the dose to 40 mg once daily depending on her blood pressure (BP) response. If Telmisartan is unavailable, an alternative is Amlodipine 2.5 mg once daily. I recommend the following lifestyle modifications:

She should follow a low-salt diet.
Monitor her blood pressure three times a day for a week, then once or twice a week thereafter. If her BP consistently remains above 140/90 mmHg, we may need to adjust the dosage. For monitoring her BP, you can purchase an electronic BP monitor from the pharmacy.
Additionally, she should maintain a healthy diet, avoiding fatty, oily, and high-calorie foods.
Encourage regular exercise, such as brisk walking or jogging, for at least 30 minutes a day, five days a week.
She should also consume plenty of green leafy vegetables, fruits, and fish once or twice a week while avoiding meat.
It is also advisable to have her lipid profile and blood sugar levels checked.

Hope this helps, and feel free to reach out if you have any further questions.