Suggest treatment to control blood pressure
Patient: I have had elevated blood pressure for about 3 months now. It is as high as 188/100. I get red rash on face, chest, and upper back. I itch all over, not just at rash sites. I ve been on a mild blood pressure pill for about 2 weeks, but I can t tell that it s helping. My blood pressure has always been on the low side, until recently. I get a low grade fever when I have the rash. This mostly occurs in the evening. I do have fibromyalgia, I ve been told. I have anemia. I m 63 year old female. I also have an awful lot of joint pain and stiffness, although, the past week it has been better. Can you help me to figure this out? Doctor: Hello!Thank you for asknig on HCM!As you are having persistently high blood pressure values, it is recommended to optimize your antihypertensive treatment.But before doing this, you must check your actual clinical status biginig with a comprehensive physical examination to address all those systemic complains you are experiencing: identify possible skin infection, inflammation or hypersensitivity, etc, articular involvements, as well as other possible body system implications.In addition, some medical tests, like resting ECG, chest X ray study, complete blood count, PCR, liver and renal function tests, thyroid hormone levels, electrolytes and fasting glucose, etc. would be necessarty to identify any possible organ involvements.If suspicions for allergy of infection are sustained, then further more specific tests would be necessary.Facing possible renal or liver function implications, an appropriate antihypertensive therapy optimisation would be feasible.You need to discuss wit hyour attending doctor (internist or cardiologist) to review all medical tests and find the right management strategy for your complains (possibly addition of combinet antihypertensives, treatment of inflammation, etc).Hope to have been helpful to you! Greetings! Dr. Iliri.