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What causes fluctuations in BP readings?

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Posted on Thu, 18 May 2017
Question: Good morning Dr. XXXXXXX You had recommended the following medicines for the treatment of high blood pressure of my elder sister:-

1. Betacap TR 40 - morning
2. Betacap TR 20 - evening
3. Amlodipine 5 mg - evening

Her blood pressure remained as follows between 18/4/17 to 30/4/17
167-90, 165-93, 150-85, 165-77, 167-80, 165-100, 155-75, 152-85, 160-90, 155-75, 157-80. On 1/05/2017, i.e. yesterday her blood pressure dropped drastically and came down to 92-50. I told her to stop the BP Medicine completely. Today the blood pressure in the morning was 125-70. Even today she has not taken medicine in the morning. The only change here was that she got throat infection and fever and she was advised following medicines by physician:

1. Zocef CV 250 - morng/eve
2. Montec LC - at night
3. Crocin SOS.

Her throat is much better now and there is no fever. Please advise further course of treatment for blood pressure.
doctor
Answered by Dr. Bhanu Partap (39 minutes later)
Brief Answer:
BP Meds Needs A Reset Now...

Detailed Answer:
Hello XXXXXXX

Thanks for reverting back with all the details, after reviewing all the bp readings its obvious and clear that her systolic blood pressure is constantly staying above the 140 target, so now i would like to change the bp medicines and will slowly titrate them up according to the need and this process might take few days to adjust the dosage. Keeping into consideration her today morning bp i would like to start her on

1. T. Amlodipine 5 mg 1tab OD (Morning)

Stop BETACAP completely. As of now i would like to continue with amlodipine only as bp is within normal range. Keep me posted with the bp reading in the follow ups so that i can add some other suitable meds according to the need.

If in case bp falls below 100 systolic and she feels discomfort then its advisable to drink some extra water along with that a cup of strong coffee and a extra bit of salt will help in that case.

And most importantly keep monitoring bp and maintain healthy lifestyle.

And also complete the course of antibiotics as advised. Do not stop in between.

Kind Regards
Dr Bhanu partap
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhanu Partap (28 minutes later)
Thanks Dr. XXXXXXX
Is T. Amlodipine 5 mg different from Amlodipine 5 mg.

Since the blood pressure today morning was 125-70, can she start the medicine from today itself.
doctor
Answered by Dr. Bhanu Partap (5 minutes later)
Brief Answer:
Hello Again

Detailed Answer:
Yes it is the same.

If bp is still around 120 systolic and 70 diastolic then you can also start with 2.5 mg or half tablet of 5 mg from today.

Kind Regards
Dr Bhanu Partap
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 2991 Questions

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What causes fluctuations in BP readings?

Brief Answer: BP Meds Needs A Reset Now... Detailed Answer: Hello XXXXXXX Thanks for reverting back with all the details, after reviewing all the bp readings its obvious and clear that her systolic blood pressure is constantly staying above the 140 target, so now i would like to change the bp medicines and will slowly titrate them up according to the need and this process might take few days to adjust the dosage. Keeping into consideration her today morning bp i would like to start her on 1. T. Amlodipine 5 mg 1tab OD (Morning) Stop BETACAP completely. As of now i would like to continue with amlodipine only as bp is within normal range. Keep me posted with the bp reading in the follow ups so that i can add some other suitable meds according to the need. If in case bp falls below 100 systolic and she feels discomfort then its advisable to drink some extra water along with that a cup of strong coffee and a extra bit of salt will help in that case. And most importantly keep monitoring bp and maintain healthy lifestyle. And also complete the course of antibiotics as advised. Do not stop in between. Kind Regards Dr Bhanu partap