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Is Medical Treatment Recommended For High Systolic Pressure?
Question: Hi. My dad is 68 years old and has hypertension and type 2 diabetes. He had a very stressful day yesterday emotionally and his blood pressure this morning is at 196 systolic. He hasn't taken his morning medicines yet. Should he take the medicines and wait and see if it goes down and if not see doctor?
And pulse is around 63.. He has always had a high systolic and low diastolic.. Dunno if its called isolated hypertension.. Also he usually has low pulse.. Jus worried cos he does have a headache and is sitting down now
And pulse is around 63.. He has always had a high systolic and low diastolic.. Dunno if its called isolated hypertension.. Also he usually has low pulse.. Jus worried cos he does have a headache and is sitting down now
Brief Answer:
I recommend giving him his morning medicine as soon as possible.
Detailed Answer:
Hello!
Thank your for asking on HCM!
I understand your concern and would explain that these values of high blood pressure are very high and are the cause of his headaches.
I would like to know, what are his mean systolic blood pressure values, so I can understand his body tolerance to high blood pressure. Anyway, the headache he has, is a sign of alarm.
You should know that these systolic blood pressure values can lead to a possible hypertensive encephalopathy (headache, confusion and seizures) and even episodes of bleeding (nose bleeding, ear bleading and intracranial hemorrhage), if not treated.
Meanwhile, you should immediately give him his morning medicine against high blood pressure and do not wait any more.
He should relax, avoid caffeine intake this morning.
I would also recommend taking an anxiolytic like alprazolam 0.25mg, as anxiety and psychological stress seems to be the cause of this situation.
If his blood pressure values don't come down in a few minutes, I recommend going to the ER for a physical examination and an emergency therapy (endovenous therapy), to help him reduce his blood pressure values.
Regarding your second question, I agree with your that the fact that he has systolic blood pressure values over 140mm Hg, associated with low diastolic blood pressure (below 90mm Hg), is called an "Isolated Systolic Hypertension".
You should know that this clinical situation is common in elderly patients.
Aging is associated with increased arterial stiffness due to endothelial dysfunction, vascular remodeling and a change in the extracellular matrix. These changes lead to a rise in systolic BP and, consequently, to the development of isolated systolic hypertension.
The increased arterial load due to increased systolic BP will promote left ventricular hypertrophy and consequently heart failure, atherosclerotic disease resulting in coronary heart disease, cerebrovascular disease and aortic aneurysms.
The primary goal of antihypertensive treatment in the elderly with systolic hypertension is to reduce cardiovascular morbidity and mortality. The goal is to lower systolic BP below 140 mmHg and diastolic BP below 90 mmHg. In case of hypertension in presence of diabetes or kidney disease, the BP target is 130/80 mmHg.
The therapy he is using (Lercanidipine and candesartan) seems to be OK for this purpose.
But an increase in the dose may be needed if his systolic blood pressure is above 130mm Hg most of the time.
Hope to have been helpful!
Feel free to ask any other questions, whenever you need!
Best regards,
Dr. Iliri
I recommend giving him his morning medicine as soon as possible.
Detailed Answer:
Hello!
Thank your for asking on HCM!
I understand your concern and would explain that these values of high blood pressure are very high and are the cause of his headaches.
I would like to know, what are his mean systolic blood pressure values, so I can understand his body tolerance to high blood pressure. Anyway, the headache he has, is a sign of alarm.
You should know that these systolic blood pressure values can lead to a possible hypertensive encephalopathy (headache, confusion and seizures) and even episodes of bleeding (nose bleeding, ear bleading and intracranial hemorrhage), if not treated.
Meanwhile, you should immediately give him his morning medicine against high blood pressure and do not wait any more.
He should relax, avoid caffeine intake this morning.
I would also recommend taking an anxiolytic like alprazolam 0.25mg, as anxiety and psychological stress seems to be the cause of this situation.
If his blood pressure values don't come down in a few minutes, I recommend going to the ER for a physical examination and an emergency therapy (endovenous therapy), to help him reduce his blood pressure values.
Regarding your second question, I agree with your that the fact that he has systolic blood pressure values over 140mm Hg, associated with low diastolic blood pressure (below 90mm Hg), is called an "Isolated Systolic Hypertension".
You should know that this clinical situation is common in elderly patients.
Aging is associated with increased arterial stiffness due to endothelial dysfunction, vascular remodeling and a change in the extracellular matrix. These changes lead to a rise in systolic BP and, consequently, to the development of isolated systolic hypertension.
The increased arterial load due to increased systolic BP will promote left ventricular hypertrophy and consequently heart failure, atherosclerotic disease resulting in coronary heart disease, cerebrovascular disease and aortic aneurysms.
The primary goal of antihypertensive treatment in the elderly with systolic hypertension is to reduce cardiovascular morbidity and mortality. The goal is to lower systolic BP below 140 mmHg and diastolic BP below 90 mmHg. In case of hypertension in presence of diabetes or kidney disease, the BP target is 130/80 mmHg.
The therapy he is using (Lercanidipine and candesartan) seems to be OK for this purpose.
But an increase in the dose may be needed if his systolic blood pressure is above 130mm Hg most of the time.
Hope to have been helpful!
Feel free to ask any other questions, whenever you need!
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He says he had headache last night and then his BP was 130/60. He has taken his morning BP meds and has gone to sleep. He didn't check his BP after taking the meds but said his headache is going down. Should I let him sleep or wake him up and check his BP
Usually his BP is controlled but can go high when he is emotional and sometimes his diastolic gets too low.. To 55 at times
Usually his BP is controlled but can go high when he is emotional and sometimes his diastolic gets too low.. To 55 at times
Brief Answer:
Blood pressure monitoring and a better anxiety control are necessary.
Detailed Answer:
Hi again,
Probably a quiet sleep will help to relieve his bout of high blood pressure. If his complain of headache is fading away, just let him relax and sleep.
Just check his blood pressure values for a couple of days (several times daily) and write them down. If persistently high blood pressure are registered, coupled with unpleasant complains (headache, etc) he needs to be consulted by the doctor to adjust the antihypertensive therapy (a possible doses increase or addition of a new drug).
Regards,
Dr. Iliri
Blood pressure monitoring and a better anxiety control are necessary.
Detailed Answer:
Hi again,
Probably a quiet sleep will help to relieve his bout of high blood pressure. If his complain of headache is fading away, just let him relax and sleep.
Just check his blood pressure values for a couple of days (several times daily) and write them down. If persistently high blood pressure are registered, coupled with unpleasant complains (headache, etc) he needs to be consulted by the doctor to adjust the antihypertensive therapy (a possible doses increase or addition of a new drug).
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks.
He just woke up and checked his BP and ots 153/72. Its no longer too high is it?
Thanks for your help
He just woke up and checked his BP and ots 153/72. Its no longer too high is it?
Thanks for your help
Brief Answer:
Give him an extra dose!
Detailed Answer:
I recommend giving him an extra dose of Lercanidipine 5 mg and follow the above advices.
Wish everything is going to be OK!
Kind regards!
Give him an extra dose!
Detailed Answer:
I recommend giving him an extra dose of Lercanidipine 5 mg and follow the above advices.
Wish everything is going to be OK!
Kind regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks.. Just checked with dad now and he said its gone to 131/65
Brief Answer:
You are welcome!
Detailed Answer:
Hello again!
I am glad to have been helpful!
Everything seems to be OK now.
I advise you follow my recommendations about closely monitoring his blood pressure in the next days.
In case of further questions, you can ask me directly at anytime on the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
You are welcome!
Detailed Answer:
Hello again!
I am glad to have been helpful!
Everything seems to be OK now.
I advise you follow my recommendations about closely monitoring his blood pressure in the next days.
In case of further questions, you can ask me directly at anytime on the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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