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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am a 69 years old female and have hypertension

Answered by
Dr.
Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 2747 Questions

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Posted on Thu, 14 Mar 2019 in Hypertension and Heart Disease
Question: I am a 69 years old female and have hypertension and bradycardia. I Take Coreg 12.5 two times daily and Valsartan 80msg one time daily in the evening .Recently my systolic has been high and pulse low. In the morning 97/62-48 and as the day progresses my systolic pressure begins to rise. At night before going to bed it can be as high as 201/69-47
What might be going on? Two years ago I had a heart XXXXXXX and the report indicated all major arteries were patently open.
I call the cardiologists office and the said to keep a record of my bp and show it to the doctor at my six month appointment in XXXXXXX .
What suggestions do you have, please.
doctor
Answered by Dr. Bhanu Partap 51 minutes later
Brief Answer:
Please refer to the detailed answer below

Detailed Answer:
Hello Ma’am

After going through the medical details provided by you I can understand your concern for your health and I would like to tell you that some people do have variation in BP readings at different times of the day so it’s important to adjust the medication and it’s dosage according to those variations.

A BP beyond 180 systolic needs medical attention, it’s highly advisable that you should meet your cardiologist as soon possible because the medications needs to be titrated.

As your heart rate is on the lower side it advisable to reduce the dose of coreg to half of what you are taking and switch valsartan to morning along with addition of 5 mg Of amlodipine in the evening.

Along with this healthy lifestyle modifications are highly recommended which includes low salt diet, daily morning walks, healthy diet, no smoking.

Also it’s advisable to get an echocardiogram done.

I hope this information will guide you properly.

Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Bhanu Partap 8 hours later
Thank you for the information!
I can’t take norvasc because it makes my Lymphedema legs swell worse. I have cyp 450 gene variance and don’t methylated some drugs properly.
Are there any other drugs you can suggest so I can ask my cardiologist?
doctor
Answered by Dr. Bhanu Partap 12 hours later
Brief Answer:
Hello again

Detailed Answer:
Okay. Then you can discuss with your cardiologist regarding addition of some diuretic medication. These are also quite helpful in normalisation of bp.

Hope to have been helpful.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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