Brief Answer: may need additional medication Detailed Answer: HI, thanks for using healthcare magic You are right in stating that the original blood pressure of 204/102 was too high.There are different stages of hypertension, that blood pressure would have fallen into the higher stage- stage 2. It could be associated with symptoms as you indicated. Persons respond differently to blood pressure readings. While your readings may cause headache, dizziness, light headed sensation in you , others may experience different or no symptoms at all. Other symptoms that can occur with high readings are blurred vision, chest pain, shortness of breath, palpitations, decreased urinary output. Lasix is a diuretic and because it would reduce blood volume (from causing fluid loss), it would cause a reduction in blood pressure. The absence of the evening dose of metoprolol would have likely contributed to the high reading. You should consider repeating the reading when you would have used the evening metoprolol. If it is still high (the upper value greater than 140 and the lower value greater than 90) , then it is possible that your doctor would need to alter your medication. There are different classes or types of high blood pressure medication. The addition of another anti hypertensive from another class may help. Right now you are taking an ARB (candasartan), beta blocker (metoprolol), loop diuretic (lasix). Your doctor may consider adding a type of vasodilator (a blood pressure medication that relaxes the blood vessels and causes reduced blood pressure). There are different types and they may help to keep the readings under control even in the am. Examples are amlodipine, verapamil, hydrallazine. Summary: repeat the readings with all medications on board, if still may need additional medication. I hope this helps, feel free to ask any other questions

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