Suggest treatment for fluctuating high BP and diabetes
Patient: Sir, my wife, 67, taking seloken 25xl and cilacar 5. Last one month, half of tablets taken from each one. Remaining time, took cilacar 5- 1/2 taken with 4 intervals based on sys pressure while reaching 160. But my doctor advice is to take medicine in the morning 1tab seloken 25xl and evening one tab cilacar 5 tab. It is all carried out in 40 days. On 3.10.14 she took half tab each seloken 25 xl and cilacar 5 in the morning. After 4hours, we noticed the BP is 202 sys, 79dia and pulse 66. My self, husband, went to Dr and informed the situation. Dr advised to take as per priscription - seloken 25 -1 tab& cilacar-5 one tab and evening one cilacar. Today, 5.10.2014, she took as per Dr s advice. intially decresed for 2hrs from 179 to137 sys, 80 to 65 dia and pulse 71 to 68. But, after that pressure increased to 190-71-77 within 1.30hrs. Immediately we went hospital.Today, OP treament is not available. Before that, to avoid any further increase, I took cilacar 5 one tab while going to hospital. After 3/4hr we measured Bp. It is 166-64-79 and further after one hour Bp is reduced to 134-60-70. she is diabetic patient more than 15yrs and 10yrs for Bp. Kindly give your good advice to relieve from this suffering. Now diabetic under control. Doctor: Hi welcome to HCM.I understand your query and concern.High blood pressure should be treated  thoroughly and should be kept under control or else will lead to complications like Dilated cardiomyopathy and ischemia to the brain.Best treatment for elevated blood pressure is through drugs like beta blockers and Ace inhibitors.Before that adequate management and work up is needed.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week.Drugs like antihypertensives and antiarrhythmics will help.Reduce the intake of fatty and fried food.One pomegranate a day will help to keep your heart at good condition. Stress management is most vital in your case.Also monitor your blood sugars regularly along with renal function tests.Continue with your present medication without fail.So Consult a Cardiologist for dose revision of your present drugs and further expert management.Post your further queries if any.Thank you.