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Taking Ramipril twice daily, Chlorthalidone. Experiencing severe head problems and heart rate is increased. Diabetic. Need cure?

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General & Family Physician
Practicing since : 2009
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I'm on 10mg Ramipril twice daily, 5mg Chlorthalidone and recently was prescribed 7-1/2mg Amlodipine. Prior to the Amlodipine, I had 3 episodes about 2 weeks apart, where I experienced severe head problems and found my BP was in excess of 200/100 which stayed slightly below that for 2-3 days before settling back to the 140-150/80 range. Since adding the Amlodipine, my pressures haven't improved or have become slightly worse than previous, and my heart rate has increased to 70-80 bum and a 93 one day. I have had labile HT previously, but not consistently and never like this. I try to do all the right things, but stillage this problem. I'm a 78 year old male and have Type 2 diabet
Posted Fri, 8 Nov 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Brief Answer:
Life style changes, low salt diet, drug dose change

Detailed Answer:
Hi and thanks for the query,

A heart rate of between 70 and 80 are within normal limits. It becomes a problem when it is persistently greater than 90 (heart rate).

A fluctuating blood pressure in a patient with diabetes is not very good. Drugs of choice in diabetic patients who are hypertensive are Angiotensin Converting Enzyme Inhibitors (Captopril,) or Angiotensin II receptor blockers.

It is already good that Ramipril, belonging to these class of drugs is good. The dose of this drug can be increased. Increasing the dosage of the drugs, under a proper monitoring of side effects should be important.

Other measures added to drug therapy are as well important. Reducing the amount of salt in the diet, exercise, well controlled diet and trying not to live under stress is important. An evaluation of life events (avoiding stress) and fighting against depression is important.

I would suggest you reduce the salt intake, have exercise well done, eat less fat and more vegetables and fruits is important. It is important to have a proper blood pressure control to avoid complications. This could involve increasing the doses of the drugs that you could be taking. This shall however deserve a proper monitoring by your doctor.

A persistently high blood pressure could arise simply from sub optimal drug dosage, depression, improper diet , lack of exercise and increased salt intake.

Thanks and kind regards. Feel free asking follow up questions in case you have any specific concerns.

Bain LE, MD
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