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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes BP fluctuations in a diabetic male?

My Dad is 90 years old. He is currently taking shots to correct his prostrate problems through his neurologist. He has a horse shoe kidney. I stopped his glipizide weeks ago because it would lower his sugar level to the 40's in the morning and now he has 98 readings in the morning. However, his blood pressure was always floating high to normal. Recently, too high 200 over 98. He is taking two medicines for HBP. What could be causing pressure increases?

                                                  
Mon, 25 May 2015
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Internal Medicine Specialist 's  Response
Hello,
Welcome and thanks for your query.
Your decision to stop Glipizide was correct. The blood pressure is high and fluctuant due to multiple factors. His kidney function would be on the decline due to age, diabetes and a neuropathic bladder. This elevates blood pressure. Another factor is the rigidity of arteries which gives a high pulse pressure. Sometimes people require upto 4 medicines to control blood pressure. If you like I can review his medicines and give my opinion.
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Internal Medicine Specialist Dr. Panagiotis Zografakis's  Response
Hello,

there are various reasons for high blood pressure excursions.
- a change in the diet, increased salt consumption (watch out for the 'hidden' salt, in cheese, salami, too much bread etc)
- severe renal artery atherosclerosis causing decreased flow to the kidneys (should be accompanied by worsening urea, creatinine, potassium levels)
- a change in the antihypertensive regimen
- cerebrovascular event (could be accompanied by various neurological problems)
- various types of discomfort (including a full bladder!)

I hope I've helped!
You can contact me again, if you'd like to ask for clarifications or further details.

Kind Regards!
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