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Suggest treatment for pain in chest and high BP

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Posted on Wed, 29 Jul 2015
Question: i am 45 yr male, my was 160/90 i was prescribed amlovas-l, nebi-h &ctd 6.25, now my bp is around under 130/80, 120/75 now my doctor stopped ctd 6.25 my bp little high now ,&pain inchest continiusly from 15-20 days...doctor is telling it is due to muscle pain....what should i do plz advice me.........
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Answered by Dr. Priyank Mody (1 hour later)
Brief Answer:
Stress test, echo and reiterate you dose of medication

Detailed Answer:
Hello, I am Dr. Priyank Mody and I be answering your concern.
As I start. something about you I would like to know, apart from hypertension want are your risk factors.
Are you diabetic, obese, do you smoke, is your cholesterol always on the higher side and you have a sedentary life. If some of the above risk factors are present. The pain you described should be evaluated further.
If a single test you want get a treadmill stress test, apart from that a 2d echo. If both are negative the possibility that your pain being cardiac is negligible, than in most probability it is muscular or stomach related gastritis.
However as you are 45 years and hypertensive you should get the above two test if possible

Now sir I think your anti hypertensive medication are not the best of combination, eg nebicard H contains hydrochlorthiazide which is same as ctd. Both are diuretic and should not be given togather.
So if you can send me the tablet, dose and what time you take them I can help you with it.
Restarting ctd as I said doesn't make sense. You may increase losartan component of amlovas L to control it
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Priyank Mody (1 hour later)
thanks for advice, as u ask ....im taking nebi-h in morning after breakfast &amlovas in night after dinner,im also taking nervisum(for back head&neck pain)in night,in morning when i woke up i feel dizzines ...im non diabetic.. i have done echo cardigram test a months ago ...it reports diastolic dysfunction grade-1 (estimatedejection fraction-65%),no rwma, normal lv systolic function, mild concentric lvh. sir plz advice me medicine, &how &when to take......
doctor
Answered by Dr. Priyank Mody (8 hours later)
Brief Answer:
Treadmill stress test, and fine titration of meds will be good

Detailed Answer:
The echo mentioned is perfectly normal, so best is to get a treadmill stress test where your heart is subjected to strain and than see how it's functioning.
In the previous question you had written amlovas L which has amlodipine and losartan combination, however here you have mentioned only amlovas. Do clarify on the same. Because your body is used to the anti hypertensive medication sudden change will send all reading go completely abnormal . Hence we may make subtle changes to control it at present.
Take nebicard h in morning and consider telmisartan 40mg + amlodipine 5mg combination at night eg tab telma Am . So two tablets per day for the blood pressure.
Do send you blood pressure taken of different day at different times after 5 days and we may review the meds. Regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Priyank Mody (1 hour later)
sir iam taking amlovas-l &nebi-h , i mis typed alovas in place of amlovas-l,sir plz clearly mention the name of medicin so i can purchase from medical store,sorry to disturb u again.....
doctor
Answered by Dr. Priyank Mody (4 hours later)
Brief Answer:
Some lifestyle changes and the medication as mentioned

Detailed Answer:
Sir I would suggest you to Cut on salt less than 3 gms a day. It means only salt necessary for cooking, no preserved food, pickles, papad, chips which contains more salt.
Exercise if you can for 30-45 mins a day for aerobic exercise like brisk walking, swimming, cycling.
In terms of medication I will suggest
Tab nebicard H (5+12.5) in morning
Tab olmesar AM (40+5)at night.

If you continue amlovas L than atleast dose is (5+50) at night
Plz keep on taking blood pressure at different times of randomly after 3days also that much time the medication will take time to act. Also any other standard brand of the medication can be taken.
Do update me the blood pressure reading
Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 910 Questions

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Suggest treatment for pain in chest and high BP

Brief Answer: Stress test, echo and reiterate you dose of medication Detailed Answer: Hello, I am Dr. Priyank Mody and I be answering your concern. As I start. something about you I would like to know, apart from hypertension want are your risk factors. Are you diabetic, obese, do you smoke, is your cholesterol always on the higher side and you have a sedentary life. If some of the above risk factors are present. The pain you described should be evaluated further. If a single test you want get a treadmill stress test, apart from that a 2d echo. If both are negative the possibility that your pain being cardiac is negligible, than in most probability it is muscular or stomach related gastritis. However as you are 45 years and hypertensive you should get the above two test if possible Now sir I think your anti hypertensive medication are not the best of combination, eg nebicard H contains hydrochlorthiazide which is same as ctd. Both are diuretic and should not be given togather. So if you can send me the tablet, dose and what time you take them I can help you with it. Restarting ctd as I said doesn't make sense. You may increase losartan component of amlovas L to control it