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What Causes Fluctuation In Blood Pressure Level?
Question: I have a blood pressure which fluctuates between 117/ 72 pulse 63 and190/98 or more pulse up to 100. I am prescribed 1; atonolol 75mg daily. Previously 50mg daily which was changed to 25 mg daily. Now 75mg.becase at the time of echo kardiogram yesterday heart rate was 85. No atenolpl taken this morning, pilserate fluctuates 63 to 75 today. Last measurement 13h 00 sa time was 150/ 97 pulse 72. Am also taking simvotin 20 mg daily, omez 20 mg daily, lasix 40 mg 2x daily.amtas 5 mg daily. Waa 10 mg. Pharmapress 10mg 2x daily, puricos 300mg isorbide 10 mg twice daily. I have abdominal pains spreading to chest giving symptoms similar to heart attack. Blood pressure shoots up then. Echo kardiograph and blood tests and ecg shows heart is strong and very healthy for 78 yesrs old. At present - 14-30sa time, 138/9$ pulse 78. How do I handle this. One momsnt pulse races reuiring med. The next pulse slow and "normal" without meds.Thanks
XXXX today my blood pressure went over 200/103 twice and was brought down using tnt. Doctor advised to take 10 mg amtas 5 x once daily
XXXX today my blood pressure went over 200/103 twice and was brought down using tnt. Doctor advised to take 10 mg amtas 5 x once daily
Brief Answer:
Dose modifications can be pretty helpful.
Detailed Answer:
Hi Sir,
I understand your concern.
You seem to have accelerated form of hypotension.
This requires combination of 3-4 drugs to control your blood pressure.
The wide variations are also accelerated by isosorbide 10 mg.
A reduction to half the dose can be helpful.
Following dose modifications are needed for effective control of blood pressure.
You are currently on 3 antihypertensive drugs.
Amtas can be taken twice a day at 10 mg dose.
Atenlol 75 can be substituted by another drug of same class,Metoprolol extended release 50 mg twice a day for effective control.
Pharmapress can be used at the usual given doses.
Please note that these drug modifications should be done only after strict consultation with your cardiologist.
And last but not least a complete renal profile including renal ultrasound and complete thyrotest is needed to rule out the secondary causes of recent onset fluctuations in blood pressure and pulse rate,particularly in the setting of normal ecg and echocardiography.
Restrict the intake of salt to less than 6 gm/day.
Post your further queries,if any.
Thank you.
Dose modifications can be pretty helpful.
Detailed Answer:
Hi Sir,
I understand your concern.
You seem to have accelerated form of hypotension.
This requires combination of 3-4 drugs to control your blood pressure.
The wide variations are also accelerated by isosorbide 10 mg.
A reduction to half the dose can be helpful.
Following dose modifications are needed for effective control of blood pressure.
You are currently on 3 antihypertensive drugs.
Amtas can be taken twice a day at 10 mg dose.
Atenlol 75 can be substituted by another drug of same class,Metoprolol extended release 50 mg twice a day for effective control.
Pharmapress can be used at the usual given doses.
Please note that these drug modifications should be done only after strict consultation with your cardiologist.
And last but not least a complete renal profile including renal ultrasound and complete thyrotest is needed to rule out the secondary causes of recent onset fluctuations in blood pressure and pulse rate,particularly in the setting of normal ecg and echocardiography.
Restrict the intake of salt to less than 6 gm/day.
Post your further queries,if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
I read your report thanks.
My immediate problem is that i will be feeling great then all of a sudden i will have a funny feel in the pit of my stomach and i could feel my blood pressure rising and on checking found it to be 185/97. My question. When bp rises that high how do i get it down. I cannot keep on using tnt. This happens a few times a day. Can you give an opinion on the pain starting somewhere in my stomach radiating into the right side chest giving symptoms just like a heart attack. Numb left arm face and leg. It is said this is not heart related. Echocardiogram, ecg and blood tests about 3-4 weeks ago were fine. Can secondary situations develop so soon? Thanks doc. I am a state patient and dependant on red tape and cannot ask for tests and meds as suggested. Will discuss and hope for best. Go well.
My immediate problem is that i will be feeling great then all of a sudden i will have a funny feel in the pit of my stomach and i could feel my blood pressure rising and on checking found it to be 185/97. My question. When bp rises that high how do i get it down. I cannot keep on using tnt. This happens a few times a day. Can you give an opinion on the pain starting somewhere in my stomach radiating into the right side chest giving symptoms just like a heart attack. Numb left arm face and leg. It is said this is not heart related. Echocardiogram, ecg and blood tests about 3-4 weeks ago were fine. Can secondary situations develop so soon? Thanks doc. I am a state patient and dependant on red tape and cannot ask for tests and meds as suggested. Will discuss and hope for best. Go well.
Brief Answer:
Have a cardiac enzyme biomarker study.
Detailed Answer:
Hi Sir,
As already said you seem to have accelerated form of hypertension,
This will a have a fluctuating course.
Its extremely important to reevaluate your symptoms through cardiac enzyme study markers.this can reliably rule out the cardiac pathology like heart attack which can sometimes be silent.
Reduce the intake of salt to less than 6 gm/day.
As stated early right dose of antihypertensives will treat your blood pressure fluctuations quite effectively.
Thak you.
Have a cardiac enzyme biomarker study.
Detailed Answer:
Hi Sir,
As already said you seem to have accelerated form of hypertension,
This will a have a fluctuating course.
Its extremely important to reevaluate your symptoms through cardiac enzyme study markers.this can reliably rule out the cardiac pathology like heart attack which can sometimes be silent.
Reduce the intake of salt to less than 6 gm/day.
As stated early right dose of antihypertensives will treat your blood pressure fluctuations quite effectively.
Thak you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you. Your suggestions were discussed with my gp. He is also of the opinion that isosorbide is the culpret. This was issued by the state hospital. After studying a record kept of hourly monitoring of bp it appeared that for a number of hours after taking meds bp was low. After a nimber of hours bp started playing up. It seens that this med did not have a long working. Initially ingredients were released fast leading to a sudden drop. He has now put me on a slow release med which has a 24 hr release period. He is keeping me on the rest as is accept for the heart rate med advising to take 50 mg instead of 75 mg for a trial period of 14 days. Do you agree with this descision?
Brief Answer:
I totally agree with your GP.
Detailed Answer:
Hi Sir.
I read your query and concern.
I totally agree with your GP meticulous approach towards restoring your low blood pressure.
Sustained release prep is an excellent option.
Dose reduction to 50 mg also seems very scientific.
Good going.Get on with your GP's management.
Thank you.
I totally agree with your GP.
Detailed Answer:
Hi Sir.
I read your query and concern.
I totally agree with your GP meticulous approach towards restoring your low blood pressure.
Sustained release prep is an excellent option.
Dose reduction to 50 mg also seems very scientific.
Good going.Get on with your GP's management.
Thank you.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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