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Suggest Treatment For High Blood Pressure
Question: hi, been taking Atenolol for 30 years (I'm 60). Dr. switched me to Toprol KL, but doesn't work as well in controlling heart rate, so switched back (50mg). Systolic is moving higher with age from the diastolic - high 150's/ but mid 80's on dysastolic. My sister and I suffer from high cortisol levels. Caffeine sometimes spike BP to 170/100, so I take extra 25mg Atenolol at night.
Pre diabetic so Thiazide diuretics increase glucose and ACE inhibitor increase potassium. Can a nightly dose of Avalide (150/12.5) at night and 50mg Atenolol in the morning work? Diuretic lower the increased potassium of the ACE inhibitor.
Please advise. Thanks!
Pre diabetic so Thiazide diuretics increase glucose and ACE inhibitor increase potassium. Can a nightly dose of Avalide (150/12.5) at night and 50mg Atenolol in the morning work? Diuretic lower the increased potassium of the ACE inhibitor.
Please advise. Thanks!
Brief Answer:
Various strategies can be followed
Detailed Answer:
Greetings and welcome to HCM. I understand your concern. Thank you for your query.
A lot of strategies may be chosen in fighting the high blood pressure, as it has now been a great amount of time that we can combine a good number of safe and effective drugs for this matter. Now, let us see. Caffeine, high cortisol, physical activity, psychological stress are all associated with high blood pressure figures.
Therefore, blood pressure measured at close time after consuming caffeine is not reliable. The main goal is to keep the BP under 140/90. To do so, my opinion is that atenolol is a very good agent since it lowers the BP and decreases the heart rate, which means that decreases the heart workload.
I would recommend it to be taken 100 mg a day, divided into two halves. Also, as a second drug, given also your age of 60 years old, I would select one of the angiotensinogen converting enzyme inhibitors (ACE-I: Enalapril, Lisinopril, Ramipril), also divided into two halves.
This is a strategy that, in my opinion, secures a better plateau level of both drugs, and regulation of the blood pressure figures. No misunderstanding, I am merely sharing my opinion, if I were your doctor. The other strategy is safe and effective as well and, yes, the combination of one drug in the morning and the other at night, is also safe and effective.
I hope I was helpful. I am happy to help, if you have follow-up questions.
Take care and regards,
Dr. Meriton
Various strategies can be followed
Detailed Answer:
Greetings and welcome to HCM. I understand your concern. Thank you for your query.
A lot of strategies may be chosen in fighting the high blood pressure, as it has now been a great amount of time that we can combine a good number of safe and effective drugs for this matter. Now, let us see. Caffeine, high cortisol, physical activity, psychological stress are all associated with high blood pressure figures.
Therefore, blood pressure measured at close time after consuming caffeine is not reliable. The main goal is to keep the BP under 140/90. To do so, my opinion is that atenolol is a very good agent since it lowers the BP and decreases the heart rate, which means that decreases the heart workload.
I would recommend it to be taken 100 mg a day, divided into two halves. Also, as a second drug, given also your age of 60 years old, I would select one of the angiotensinogen converting enzyme inhibitors (ACE-I: Enalapril, Lisinopril, Ramipril), also divided into two halves.
This is a strategy that, in my opinion, secures a better plateau level of both drugs, and regulation of the blood pressure figures. No misunderstanding, I am merely sharing my opinion, if I were your doctor. The other strategy is safe and effective as well and, yes, the combination of one drug in the morning and the other at night, is also safe and effective.
I hope I was helpful. I am happy to help, if you have follow-up questions.
Take care and regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Do these ACE inhibitors increase the potassium levels?
Many thanks.
Many thanks.
Brief Answer:
Possible, but not disturbing
Detailed Answer:
Hi again.
It is a possibility for a slight, clinically not significant, of potassium increasing, while on ACE-Is. However, a 6-monthly control of creatinine and potassium levels are recommended in cases of using this class of drugs.
I hope my follow-up is helpful. If you do not further questions, kindly close the discussion and rate the answer.
Best regards,
Dr. Meriton
Possible, but not disturbing
Detailed Answer:
Hi again.
It is a possibility for a slight, clinically not significant, of potassium increasing, while on ACE-Is. However, a 6-monthly control of creatinine and potassium levels are recommended in cases of using this class of drugs.
I hope my follow-up is helpful. If you do not further questions, kindly close the discussion and rate the answer.
Best regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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