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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Are The Possible Treatments For New Onset Diabetes?

Hi, my dad had CVA in May 2012 and found to have new-onset diabetes at that time too. He was put on amlodipine 5 mg and atenolol 50 mg for hypertension by which his diastolic BP remained in 78-80 range, pulse 65-80, but systolic BP continued in the range of 150-160 (left arm, sitting, home monitoring) with ankle edema (only when he was sitting on a chair, not in supine position). He was put on cilnidipine 20 mg and atenolol 50 mg since January 8, 2014 by advice of a medicine specialist, but now his systolic BP remains 155-180. Should he needs to be added with s-smlodipine 1.25 mg or amlodipine 2.5 mg to bring his SBP down? Diuretics are not advised as he was having cerebral salt wasting syndrome and was put on Florinef (fludrocortisone) 50 mcg daily for over a year and stopped when he was started with cilnidipine. You advice would be greatly appreciated.
Wed, 22 Jan 2014
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Internal Medicine Specialist 's  Response
hi, many patients with CVA develop hypertension as a protective measure of keeping brain perfusion pressure. gradually it stabilizes at a point. in your dad's case, it may respond to ACE inhibitors, which is worth trying. salt wasting generally donot correlate with uncontrolled blood pressure. hence it is required to rule out any secondary causes of hypertension like renal artery stenosis or hyperaldosteronism. hope this helped.
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What Are The Possible Treatments For New Onset Diabetes?

hi, many patients with CVA develop hypertension as a protective measure of keeping brain perfusion pressure. gradually it stabilizes at a point. in your dad s case, it may respond to ACE inhibitors, which is worth trying. salt wasting generally donot correlate with uncontrolled blood pressure. hence it is required to rule out any secondary causes of hypertension like renal artery stenosis or hyperaldosteronism. hope this helped.