Brief Answer:
I were to watch and then titrate dose

Detailed Answer:
Hi dear.Thanks for writing me back.

I am glad that you have been started on Telmisartan and you may not have any side effects.Would like to know how long you have been on Telmisartan?

Your systolic pressures are borderline high(> 10mm; normal is 150mm according to the latest recommendations) which is still pretty good.This has to be observed over sometime and then the dose can be titrated further up if required.I always prefer doing so since it is not advisable to bring the pressures down suddenly(because the body would have adopted to those high pressure of yours).Moreover diastolic pressure is very well controlled(<90 being normal).I would wait, watch and then titrate the dose.

Dry mouth, dry eyes and hair fall is rarely seen as a side effect with Verapamil.I were to advise artificial tear (administer 3-4 times per day) to relieve your ocular symptoms.Few tips to overcome dry mouth are:
Sipping water or sugarless drinks
Avoiding drinks with caffeine, such as coffee, tea and some sodas. Caffeine causes dry mouth.
Avoiding spicy or salty foods which may cause pain in a dry mouth.
Mint flavored candies (sugarless) can also be a good choice.

I were opt for change of the medication(Verapamil) if these symptoms are intolerable & only after your Systolic Blood pressure comes under control.
Brisk walking, meditation also help in reduction of blood pressure.
Reduce the salt intake (not more than 2g/day)
Regular medication helps achieve better BP control.
It is advisable to avoid tobacco, alcohol(if any).

Hope this answers your query.

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Brief Answer:
Watch for a month before adding second drug

Detailed Answer:
Hi dear.Its my pleasure to help you stay healthy & fit.

So, I understand that you have been taking telmisartan and doing well on this medication.I was awaiting to listen about your lifestyle; willing to know if you have been- walking, reduction of salt intake, yoga etc.

Do you have diabetes, any history of heart attack, stroke or any other health related issues in your past?Please specify if you have been using any other medications

I were to watch your blood pressure levels for a months time and then were to add a second drug preferably diuretic(but not amlodipine since it belongs to same group which verapamil belongs to).This is the current standard of care(evidence based).Hope lifestyle modification along with the medication shall keep your pressures at bay.

Hope you have been getting your pressures check at the clinic regularly.If you have been measuring at home make sure that the device (electronic) is calibrated so that it records the correct numbers.
Would advise to maintain a dairy and note these levels with date and time.
Be regular to medication.

Donot worry.Be stress-free.Stress also increases your pressures.

You shall get well soon.

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Brief Answer:
Continue the same treatment

Detailed Answer:
Hi dear.You are most welcome.

Lets ignore diuretics in that case.

I am glad that the BP is 158/70, with no medical history and a check on salt intake.I would always verify this reading with the sphygomamometer(gives most accurate reading amongst all BP devices) reading in my clinic.

I am sure that the pressures shall improve with walking and meditation.Plan for regular follow up with you MD.As discussed pressures after one month of treatment will give an idea whether to titrate further up or add a second medication.

Good day.

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