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Dr. Andrew Rynne

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Suggest treatment for high systolic and low diastolic readings

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Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4361 Questions

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Posted on Thu, 10 Sep 2015 in Hypertension and Heart Disease
Question: my systolic bp is very high and my diastolic bp reading is very low. My doctors cannot seem to correct the problem. Can you please help me? THANKS XXXXXXX XXXXXXX
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Answered by Dr. Rakesh Madhyastha 17 minutes later
Brief Answer:
Systolic blood pressure

Detailed Answer:
Hello

Thanks for the query

Isolated systolic hypertension is well known in patients above 65 years of age. I can certainly help you with it. I have gone through your medications however to make changes I will need to know your average blood pressure readings.

When you say high systolic and low diastolic what figures are you referring to?
Could you please furnish your ECHO findings if it was ever done

Please get back to me, I am awaiting your reply

regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rakesh Madhyastha 11 hours later
Dr. XXXXXXX Madhyastha. Thank you for your reply. My average systolic and diastolic bp readings are: 189/57 with an average heart rate of 54. On my last echocardiogram, the doctor said that the results were okay. Thanks, XXXX XXXXXXX
doctor
Answered by Dr. Rakesh Madhyastha 11 hours later
Brief Answer:
Raised systolic blood pressure

Detailed Answer:
Hello

Thanks for getting back. I am sorry for the short delay in my reply, it was an extremely busy day at the hospital

Here is what you should do

1. The systolic blood pressure aim should be for 150mmhg
2. I recommend you to continue the blood pressure medications you are on and in addition I would like to add an ace/arb. I usually start tab telmesartan 40mg once daily and go up to 80 mg twice a day depending on how patients tolerate it. This will help reduce systolic hypertension. It has additional properties of protecting the heart and kidneys apart from lowering blood pressure
3. The most important thing to reduce systolic hypertension is to get your salt intake in check. Make sure that you follow a strict salt restricted diet. That is, do not consume anything high in salt like chips, popcorn, pasta, Etc.
4. Get an echo done, aortic stenosis can lead to a blood pressure like this. It can be missed on an ekg

I am once again sorry for the delay. If you have any further queries please get back to me

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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