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Why is my mother waking up with high blood pressure while taking Norvasc and metoprolol and suffering from sleep apnea?

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Internal Medicine Specialist
Practicing since : 2009
Answered : 3026 Questions
81year old mother on Norvasc and metoprolol, both taken at night. Blood pressure taken during day and after the meds is ~135 to 140 over 65 to 75, pulse mid sixties. She wakes a few hours later with high blood pressure - higher than before the meds 165 to 185 over 70 to 85, pulse 90 to 105. Overweight but not obese. Prone to kidney stones and kidney sand. Since I have sleep apnea and the symptoms before diagnosis were near identical, I suspect lack of Oxygen, however I want a check on any possible side effects of her medications.
Posted Tue, 21 Jan 2014 in Hypertension and Heart Disease
Answered by Dr. Anshul Varshney 34 minutes later
Brief Answer: Requires Workup. These meds not the reason. Detailed Answer: Dear Friend Thanks for writing to us. She is hypertensive on treatment. Your query is regarding her sudden getting up in night with blood pressure on higher side. If she gets up in middle of night with breathless , it might be Paroxysmal Nocturnal Dyspnoea , which can be a sign of cardiac disease. Higher Blood pressure readings during that time can be due to dyspnea and anxiety caused by it. If she has sleep apnea , you can see that , a person gasps for breathing with a large snout sound in sleep in obstructive sleep apnea. The person has a disturbed sleep leading to day time sleepiness and tiredness , but usually a person doesn't get up from bed during sleeping. The person is actually unaware of that he / she got up several times in night!! This kind of problem is not caused by the medications she is taking. However , I advice following investigations : 1. Echocardiography 2. ECG 3. Lipid profile 4. Kidney function test 5. Liver function test 6. Hemogram 7. Urine routine and microscopy 8. Xray Chest. An Arterial bloog gas analysis and sleep study will be required if symptoms and these investigations are normal or suggestive of sleep apnoea syndrome. I hope I am able to solve your query , still if you have any query ask me.
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