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    Suggest treatment for high blood pressure

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Posted on Tue, 24 May 2016 in Hypertension and Heart Disease
Question: I HAVE STAGE 2 HIGH BLOOD PRESSURE. MY DIASTOLIC AND HEARTRATE ARE GREAT, WHAT MEDICATION ISBEST AND IS IT AVAILABLE IN TIME RELEASE.......I AM 80 YEARS OLD
doctor
Answered by Dr. Ilir Sharka 22 minutes later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I would explain that it is important starting with at least two antihypertensive drugs (dual therapy) like a ACEI (lisinopril, enalapril,etc.) / ARB(valsartan, irbesartan,etc.) and a calcium channel blocker (amlodipine, lercanidipine,etc.).

Beta blockers may be added depending by the outcomes of the above combinations, to achieve better results in controlling high blood pressure.

As there are no pre-specified anti-hypertensive schema for stage II or III blood pressure, the maintenance therapy would depend by the achieved outcomes of the applied therapy.

The desired goals of blood pressure values would be below 140/90mm Hg.

Hope to have been helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 hours later
THANK YOU FOR YOUR QUICK RESPONSE HOWEVER YOU FAILED TO ANSWER MY QUESTION ABOUT WHICH TIME RELEASE MEDICATIONS WOULD BE GOOD, PLEASE PROVIDE ME THE NAMED PRODUCTS, THANKS VERY MUCH..............
doctor
Answered by Dr. Ilir Sharka 8 hours later
Brief Answer:
Opinion as follows:

Detailed Answer:

Dear Sir,

Among the options I mentioned above there are also time release medications (such as lisinopril, valsartan, irbesartan, lercanidipine, amlodipine but also other alternatives as well, such as olmesartan, telmisartan, felodipine, etc.)

The above mentioned drugs are time release (sustained-release [SR], extended-release [ER, XR, XL].

The best strategy would be to combine an ACEI (Lisinopril 10-20 mg/day, or Ramipril 5-10 mg/day, etc) or an ARB (Valsartan 80-160 mg/day, or Olmesartan 10-20 mg/day, or Irbesartan 150 mg/day, etc) with a calcium channel blocker (Amlodipine 5-10 mg/day, or Lercanidipine 5-10 mg/day, or felodipine 5-10 mg/day,etc)

Also time release beta-blockers (Nebivolol 5-10 mg/day, or Bisoprolol 2.5-5-10 mg/day,etc) may be necessary to add to the above combination.

Depending on the first 1-2 weeks therapy response, the subsequent dosages and scheme are properly adjusted.

As I explained above there are no predefined anti-hypertensive schemes.

It will depend on your attending doctor decision which of the alternatives could be an initial combination.

Before starting an anti-hypertensive therapy it is necessary to check some lab tests to make sure there are no secondary causes of hypertension or any organ dysfunction which could interfere with your therapy:

- complete blood count,
- FT3. FT4, TSH
- liver function tests,
- renal function tests,
- blood electrolytes level,
- etc.

I am sorry about not providing you trade names of the above mentioned medications. It is not the policy of our site to make such publicity.

You need to discuss with your doctor and pharmacist on the available medications in your living area.

Hope you will find my answer of some help!

Nevertheless, if you have further uncertainties, I remain at your disposal for every explanation.

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 4 hours later
thank you again for your answer, could you tell me if the types you have already given me are available in time release form and if so, and if you are in a position to name the product. I understand that you may not be in a position to recommend specific product, thank you again......................


thank you so very much, that information will be very helpful. i am a big fan of life extension foundation and am a lifetime member, most all of my hormones are that of about a 30 year old working out in the sun, with natural vitamins and supplements I have completely eliminated severe type two diabetes, for the last 14 months my a1c has never been more than 4.8, my last one in January 16 was 4.3,prior to that I was taking 70 units of insulin in the morning and again at night, I thank u so much for sharing your wisdom with me....................
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
You are welcome!

Detailed Answer:
It seems you are on the right way of dealing with your health problems.

You have done a perfect work controlling your diabetes (which is one of the main coronary risk factors directly influencing on life longevity).

I am sure you are going to optimally manage also you high blood pressure.

Being near the nature and feeling active during the day is the best way of improving your health.

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

Wishing you a good health!

Regards,

Dr. Iliri

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

Cardiologist

Practicing since :2001

Answered : 7356 Questions

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