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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes dizziness and soreness on the chest despite taking Cozaar?

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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Posted on Mon, 27 Mar 2017 in Hypertension and Heart Disease
Question: My BP has been 155/105 for 3 days. Chest sore. Dizzy
Took 50 mg Cozaar this morning but it doesn't seem to want to go down
I am v healthy 66 yr old female. Had a BP spike 4 months ago, (as a result of too much estrofem hrt) and now it roller-coasters
For days it is 126/80 and I feel good. Then something spikes it
Should I take more cozier?
doctor
Answered by Dr. Rishu Saxena 1 hour later
Brief Answer:
No don't take cozier instead take a single dose of nitrate.

Detailed Answer:
Hi,
'Thanks for asking your query on HealthcareMagic,

Control of fluctuating bolod pressure is achieved better on patients taking calcium channel blocker like amlodipine and thiazide diuretics like hydrochlorthiazide in various trials done on patient.
Right now you are on AT1 antagonist class of anti hypertensives,Though they are good;yet in patients experiencing fluctuations and spikes in blood pressure,Results with amlodipine are far better as compared to losartan in trials.

As off now you can ask your cardiologist to shift you on monotherapy with amlodine for preventing such spikes in future.

Most commonly spikes in blood pressure is caused due to dysautonomia or pheochromocytoma.
I would suggest you to check you blood Vinylmandelic acid and Metanephrine levels checked to rule out possibility of Pheochromocytoma.

Till that time its more advisable to take a single dose of Nitrates like Isosorbide monotrate on days when you experience spike.They are venodilator and decreases blood pressure quickly and are much safer then AT1 antagonist for As and when require dose.

Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Rishu Saxena 1 hour later
Thank you for your reply. It is quite informative and explanatory which I like
Questions please ..
1. I have possession of dyna indapimide pills also - is that the same as the monotherpay amiodine you suggest?

2. I shall try the nitrates for spikes - sounds interesting
regards XXXX



doctor
Answered by Dr. Rishu Saxena 3 minutes later
Brief Answer:
Amlodipine is safer

Detailed Answer:
Hi again,

No Indapamide is a diuretic while Amlodipine is a calcium channel blocker. Amlodipine is much better and safer as compared to Indapamide.
Thank you very much!
In case you have any other query please feel free to ask.
Please do Rate the answer.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Rishu Saxena 23 hours later
`Thank you for your answer
It was Sunday and couldnt get Nitrate without a script. So I ate lots of beetroot (apparently high in Nitrate) and felt better
This morning I am v dizzy 115/93 -feel uncomforable
I get a bit scared when bottom reading goes above 90 . Is over 90 a problem?|
I do have slight pain in heart area
Am not sure i I panic and cause half the problem or not
2x I have taken 1 quarter of an ativan pill and it seems to help
question is : If I am on something like aniodpine wouldn't my BP go v low also?
doctor
Answered by Dr. Rishu Saxena 20 minutes later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Firstly dizzines is not because of blood pressure9115/93mm of hg is perfectly normal blood pressure for femlaes,this won't make you dizzy).
Target blood pressure above age of 40 is less then 140/90mm of hg.93 is almost near target only.
As the pain is relieved on taking Ativan its very likely that its non cardiac pain,Due to increased anxiety levels.However to be on safe Stress test can be done to rule out coronary artery disease.

For query regarding amlodipine you are on Cozaar already,which is a potent antihypertensive.So ask your cardiologist to shift you from Cozaar to Amlodipine(As control of fluctuations is better with amlodipine then AT1 antagonists).
Amlodipine should be started at minimum dosage of 2.5mg once daily and doses can be increased depending on response of your body.

Thanks.


Above answer was peer-reviewed by : Dr. Remy Koshy
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