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Have had heart attack and strokes. Taking metformin and lisinopri. What cure should be done?

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General & Family Physician
Practicing since : 1978
Answered : 6593 Questions
Dear Dr Grief,
My wife's pressure has been 160/ 100
She has had 2 heart attacks and 4 strokes, so this makes me crazy when I see these numbers
So we started giving her 2 20 mg pills/ day (lisinopril)
This evening before her 2 nd dose her b/p was 104/73 so I did not want to give her the 2 nd pill, maybe half
Well we are both ND not MD so here I am looking for a referee. She is 72, 5 2 wt 108 and quite a scrapper, plus the only love of my life. She likes to take 6 cayenne/ garlic from Solaray which has nutritional benefits besides the pressure balancing effects. Thank you for your since our discussion her b/p went up to 150/80, so I am now inclined to give her the 2nd pill or at least half. Thanks again. (Metforman 2 x2/day
Posted Mon, 18 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Pavan Kumar Gupta 2 hours later

Thanks for the query.

Your query states that your wife is having both diabetes and hypertension and is on METFORMIN 2 tab 2 times a day along with 20 mg of lisinopril twice a day.

Hypertension is twice as common in individuals with diabetes as compared to normal persons.Diabetes increases the risk of coronary events twofold in men and fourfold in women.In observational studies, people with both diabetes and hypertension have approximately twice the risk of cardiovascular disease as non-diabetic people with hypertension.

 Hypertensive diabetic patients are also at increased risk for diabetes-specific complications including retinopathy and nephropathy. 

The target blood pressure to be achieved for your wife should be below 120 for systolic blood pressure and below 80 for diastolic blood pressure meaning thereby that the target should be below 120/ 80 mm of Hg.

If your wife is not complaining of any symptom of low blood pressure like uneasiness or headache,then there should be nothing to worry and you may keep giving the prescribed dose of 20 mg twice a day.However if she does complain of some problem,then this dose should be around 10 mg twice a day and if her BP is not settled then an additional anti-hypertensive of some different class should be added to her treatment.

I hope your wife is receiving this anti-hypertensive treatment for a long time or it has been started recently? 
You keep monitoring her blood pressure and if it is found that she is repeatedly getting lower values,then it would be better to reduce the dose to 10 mg twice a day,but after talking to your treating doctor.

Keep her sugar levels in control.
Keep giving her garlic pearls.

I hope it helps however you may revert to me for any further query.

Best of luck
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