What causes elevated diastolic pressure despite taking Losartan?
Patient: My blood pressure has been sky high 180/110 range. I take losartan 25 mg a day, recently increased to BID. Also diltiazem XR 120 daily, HCTZ 25 mg daily, 81 mg baby aspirin. I have had 2 episodes of a fib in the past 2 years. I can t tolerate lisinopril or metoprolol. Why is my diastolic so high? I am so afraid of having a stroke. Doctor: Hello and Welcome to ‘Ask A Doctor’ service.  I have reviewed your query and here is my advice.  After going through your medical details I understand your concern and I would like to tell you that your diastolic and systolic both pressures are high which needs proper management. You are already taking anti-hypertensive shut may require to increase the dose and for atrial fibrillation you need special blood thinner instead of aspirin. Kindly consult a cardiologist personally and discuss to start Debigatron or Warfarin and ask him if you need dose modification for high blood pressure.  Hopefully this information will answer your query. Kind Regards, Dr. Bhanu Partap