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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for systolic hypertension

Answered by
Dr. Rishu Saxena


Practicing since :2012

Answered : 696 Questions

Posted on Wed, 22 Mar 2017 in Hypertension and Heart Disease
Question: I am 66 years old,male Asian,I am on 320mg/12.5mg valsartan Hctz and 5md ampodipine.My bp monitor in the morning(after work out 1 hr) average 125-130/65-70 and afternoon(5-6PM) 160-170/80-85.My problem may be isolate systolic hypertension.What type medications need to lower my systolic and keep my diastolic same.Thanks.

Answered by Dr. Rishu Saxena 1 hour later
Brief Answer:
Add nitrates.

Detailed Answer:
Thanks for choosing HealthcareMagic for your query.
I would suggest you to add nitrate to your regimen.
Nitrates are very effective in lowering systolic blood pressure and has minimal effect on diastolic blood pressure.
A long acting nitrate like isosorbide mononitrate 30 mg slow release tablet should be taken every day.
Please discuss options with your cardiologist.
Dr Rishu

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Rishu Saxena 1 hour later
My average heartbeat 58-65 per minute add nitrate can cause any problems?thanks.

My doctor prescripted Benicar 40mg/12.5mgHCT.I found out this drug too expensive and no generic available.Can you provide me the list of drugs working similar as close as to Benicar and generic available(olmesartan medoxomil-hydrochlorothiazide).Thanks.
Answered by Dr. Rishu Saxena 2 days later
Brief Answer:
Follow up answer

Detailed Answer:
Hi again,
No nitrates are not going to cause bradycardia,As they will decreses the blood pressure so mild increase in heart rate can be noted,Which will be good for you.
Olmesartans generic version is still not there in market so instead you can take MICARDIS(Telmisartan)40mg in combination with chlorthiazide.


Brief Answer:
Follow up answer.

Detailed Answer:
Nitrates will be safe for you as reduction of systolic blood pressure will increase you heart beat which is good for you.However as such nitrates have no direct effect on heart rate.
Above answer was peer-reviewed by : Dr. Remy Koshy

The User accepted the expert's answer

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