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Suggest Treatment For Uncontrollable BP Readings In A Person With Lung Problems

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Posted on Thu, 4 Jun 2015
Question: Dear Mr. Shedu

Long time not being in touch with you

Since i wrote to you last time i have been checked for sleep apnoea and was told i do not suffer with this condition

For my blood pressue I was started with Ramipril 1.25 mg , once a day. This did not work as i was getting readings of 165//110 mainly in the middle of the night. MY GP increased it to 5 mg. My BP was still not controlled, i had hiogh readings during day and night. Finaly, after a month, i saw a cardiologist and he started me on 10 mg of Ramipril. During this time my heart was checked- treadmill test and myoview test and i have been told my heart is ok. During the myoview test, whilst i was on a treadmill, my BP increased to 180 so they had to stop the test. The 10 mg of Ramipril (5 in the morning and 5 in the evening) was not working at night. So i went back to the cardiologist and he gave me indapamide, 1.5 mg to take one pill at night. BP was still high,but not that high as before . At night the BP was 148/94 and pulse was 86. On 18 April at 14.12 pm my bp was 134/84 with pulse 109!!! this was at rest. I had to stop the indapamide as i was getting very dizzy, extremely weak and not able to breath (breathing was a bif effort as i had no energy left). I went back to my GP and instead of indapamide they gave me amlodipine 5 mg. On 1st of May 2015 at 5.24 am my bp was 173/110 with pulse 92. I went back to my gp to tell him the BP tablets are not working but he said i need to drink a glass of red wine in the evening to relax. I dont think this is a good idea given the fact that i take olanzapine 2.5 mg for my previous psychotic episode of 5 years ago

Last week i went to romania to visit my family and went to see a cardiologist. She replaced ramipril with Telmisartan 80 mg (to be taken in the moring ) and amplodipine was increased to 10 mg (to be taken in the evening). MY BP is now stable even during the night but i do feel very very weak, a little bit dizzy and my pulse is not falling below 90 (even at rest). One our ago my pulse was 108, at rest. I am seeing the cardiologist in romania again tomorrow- she placed a holter machine on me. I am really worried about my pulse now. I have to mention that if i go up the stairs my hearts start bitting very very fast and i can feel it bitting in my throat.

Please advise me what to do to decrease my pulse. Do you think the pulse is a reaction of the medication. Before taking the BP tablets my pulse was beteen 70-80. Also, why do i feel so weak? MY sugar level is borderline so i am on diet now- just has been discovered last week. Also, i would like to remind you that i am overweight ( 90 kg and height 1.64 cm). My blood test results were fine, with the exception of vitamin D which is very low.

Given my high pulse, is it advisable to exercise? if yes, what kind of exercise is good for me?

Thanks a lot and i will keep you updated
I would like to mention also that i had ECG done and heart eco and everything came out fine.

Regards

XXXXX
doctor
Answered by Dr. Benard Shehu (9 hours later)
Brief Answer:
Following advice...

Detailed Answer:
Hi back XXX,

I have gone through your concerns and I can say as following:

To my opinion, you should be using nebivolol as it is a third generation beta selective blocker recommended in patients with lungs problems as in your case. Since this is a medication should discuss with your doctor. With such a case at my clinic we begin with a starting dose of 2.5 mg.

I also recommend to :
- take magnesium supplements
- limit carbonated drinks
- avoid caffeinated drinks/foods

With regards to exercise, Yes, you can safely exercise as it will help improve your cardiac frequency and relieve stress. If you are more physically active, your heart will work better too and keep fit and healthy.

Hope it answered to your queries!
Dr.Benard
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (4 minutes later)
Dear Mr. Shedu

Thanks a lot for your reply

Please let me know if nebivolol is for blood pressure? How about my pulse? What can i do to decrease it?

Many thanks

Good night

XXXX
doctor
Answered by Dr. Benard Shehu (8 minutes later)
Brief Answer:
Following advice...

Detailed Answer:
Hi back,

Nebivolol will control and stabilize both your heart rate and blood pressure. It has a beta blocker effect that help to control your HR and a vasodilatation effect that help on lowering your BP.

This is why I strongly suggest to take Nebivolol, however you should discuss this with your doctor.

Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (34 hours later)
Hi

My doctor here in romania prescribed me yesterday Nebivolol (2.5 mg in the morning, 2.5 mg evening) and to increase to 5 mg morning and 5 mg evening if required. The pulse is lower now (and the BP). However, i forgot to ask her if it matters that i take olanzapine 2.5 mg for my 2010 psychotic episode.

Many thanks for your brilliant advice

Regards

XXXXX
doctor
Answered by Dr. Benard Shehu (56 minutes later)
Brief Answer:
Following advice.

Detailed Answer:
Hi back XXXXX!

You should continue with the prescribed dose of Nebivolol and you shouldn't increase the dose as long as your HR and BP are stabilised.

Moreover you may continue with olanzapine, you don't need to take any special measures for that.

Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (18 minutes later)
Dear Mr. Shedu

I took my blood pressure now. 2 hours after telmisartan and Nebivolol and the BP is 107/72 with pulse 85. Is the 107 reading not too small? Should not be around 120 under medication? I am worried now that i take too much medication:-)
i would like to add that the readings when i woke up were 130/89 and pulse 96 ( last night i took first tablet of Nebivolol)
Many thanks

XXXX
doctor
Answered by Dr. Benard Shehu (4 hours later)
Brief Answer:
Following advice.

Detailed Answer:
Hi back XXXX!

As long as your BP is below 140/90 mmHg and your systolic BP is above 90 mmHg (in your case 107 mmHg) you shouldn't worry about taking to much nebivolol.

My advice is to stay kalm and to continue with the prescribed dose of Nebivolol.

Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (54 minutes later)
Thanks a lot Mr Shehu

Sorry for misspelling your name so many times

Regards

XXXX
doctor
Answered by Dr. Benard Shehu (7 minutes later)
Brief Answer:
Wish you health!

Detailed Answer:
Hi back XXXX and thank you!
Wish you health!

Dr. Shehu
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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Suggest Treatment For Uncontrollable BP Readings In A Person With Lung Problems

Brief Answer: Following advice... Detailed Answer: Hi back XXX, I have gone through your concerns and I can say as following: To my opinion, you should be using nebivolol as it is a third generation beta selective blocker recommended in patients with lungs problems as in your case. Since this is a medication should discuss with your doctor. With such a case at my clinic we begin with a starting dose of 2.5 mg. I also recommend to : - take magnesium supplements - limit carbonated drinks - avoid caffeinated drinks/foods With regards to exercise, Yes, you can safely exercise as it will help improve your cardiac frequency and relieve stress. If you are more physically active, your heart will work better too and keep fit and healthy. Hope it answered to your queries! Dr.Benard