Question: My wife 52 yrs has dm type2+ essential ht since few yrs. Her ht when controlled with losartan 50 bd plus bisaprolol 5 mg once daily shows a systolic brachial bp of 150 to 160 mm vs 75 to 85 .and at times of stress likejourney, sleep distubances bp goes up to 180/95 etc. When she was under control with amlodipine 5 mg+ atanalol 50 mg consequent on unstable angina she developed severe pedal edema and reverted back to losartan plus bisaprolol.
Present query - Should we be concerned abt her bit higher systolic bp given above? or she need to be changed over to other drug/ combinations?

While on losartan+indapamide for ht , about3 months back after unusual food ie parottasand chicken curry in the evening she developed retrosternal unstable angina and hospitalised for observation- mild ecg variations stabilised, trop test negative, echo results not alarming with normal vessels ,valves and blood flowrate. Follow up tmt 3 weeks later reported with fatigue after 4 minutes and 20 sec acivity, though excercise induced ischemia was not noticed

Rosuvastatin5 mg + aspirin 75 mg nowgiven at night as cardioascular/ clot preventive after the chest pain episode

consulted a dabetologist cum physician, opined that she be tried with metoprolol+clinidipine as her bp was under better control while on amlodipine+atanalol, also said that this is better option in view of the risk of atanalol and peripheral edema in amlodipine, clinidipine