Question: My Mother is 83 years old. Has history of Atrial tribulation, high blood pressure, high cholesterol, diabetes. She had ablation treatment 10 years ago and AF has been in control until recently. She started to have some episodes occasionally but not as high and as frequent as 10 years ago. Recently 2-week Holter tests have not yet caught any. Her blood pressure fluctuates. The most challenging aspect for her is sleep problem. it is hard to say what is the cause and what is the effect. But I feel the combination of lack of sleep, fluctuating blood pressure and occasional heart beat problem are a bit of a vicious circle. She also has a bit of anxiety, not to the degree of depression but rather constantly anxious about and dramatize little things. We recently consulted her family doctor who recommended low dose Trazodone to help with anxiety but she has not yet seen any effect. She has no mobility issue and her mind remains sharp at 83.

My questions are:
1). Do you have some general recommendation of her situation to break out of the vicious circle?
2). Specifically, I understand cholesterol medication might have side effect on anxiety etc. She is currently taking Rosuvastatin 5mg 1 tablet daily for a few years. However her cholesterol level has been quite on the low end. Recent blood test shows 3.73 mmol/L Cholesterol, 2.32 mmol/L HDL and 1.14 mmol/L LDL. I wonder if there is a chance to lower her cholesterol medication? say, to 0.5 tablet daily?
3). She seems to be taking a lot of medications on daily basis. She is a bit concerned about the impact on her stomach, kidney, etc. (She was quite hesitating to take Trazodone but she is also aware her anxiety issue so she is taking it grudgingly.) I hope to seek your advise on this issue - is the variety of medication she is taking on the high end and should she be concerned?

Thank you in advance for your help.

Helen

Thanks a lot Dr. Sharka for the prompt response! Really appreciate your advice! A follow up question - she is concerned with the number/volume of medication she is taking and impact to her digestive system and kidney. She does seems to take a variety of medications, but they all seem to be valid to deal with specific aspects of her illness. Is this something a concern?