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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 currently am on an extended trip to Florida

Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7011 Questions

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Posted on Sat, 2 Mar 2019 in Valvular Heart Disease
Question: I am currently am on an extended trip to Florida and my primary care physician and clinic is located in XXXXXXX On XXXXXXX 28 2019 I went to the ER in Florida with chest pains. They kept me and administered EKG and blood tests and confirmed I didn't have a heart attack, however my BP was consistently high around 178/108. Over the course of the stay, the attending ER doc took me off Losartan and started me on Norvasc 5mg. On Feb 1 I was seen as a follow up at the Florida hospital and the BP was still the same but the doctor I saw did not change the medication. She did ask me why I wasn't taking the Losartan with the Norvasc and I showed her the ER actions saying not to take the Losartan.
Since then my BP has consistently been in the 160/94 range (I've been monitoring it), so I called my primary care physician in XXXXXXX who told me to increase the Norvasc to 10mg.
I've now been on the Norvasc 10mg for 3 days and the BP is still the same, measuring 146/100 at 6:54am and 174/101 at 9:11am, and 160/106 at 10:14 am today. I am using a BP monitor from the drug store.

My question is should I go the the ER (insurance is better if I go there vs Urgent care)? I will be making an appointment with my Dr in XXXXXXX but will not be able to see her for at least a week.

Thank you.
doctor
Answered by Dr. Ilir Sharka 35 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would explain that your blood pressure values are still above the normal ranges.

This means that your current therapy is not very effective in controlling blood pressure values.

Anyway, every change in blood pressure drugs (like increasing the dose of Norvasc) may need up to a week to show its effects and achieve a new balance in blood pressure values.

For this reason, I recommend checking frequently during the next day blood pressure values.

If after a week, your blood pressure values are still above the normal ranges (125/85mm Hg) most of the time, I would recommend adding a new drug to your therapy (an ARB like losartan, valsartan, etc.. or ACEI like ramipril, enalapril, etc..).

There is nothing wrong in combining two drugs like losartan and Norvasc (I don't understand why the ER doctor stopped losartan, before starting Norvasc).

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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