Suggest the best treatment for High blood pressure

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On what medicines is she on at present..That was to be posted first to review the further amanment... DM & Thyroid profile are slso advisable to be done. Hypertensive cardiac myopathy also to be assased for. I am not of opinion to suggest the drugs with out confirmed investigation and diognosis. My impression is HT is not the disease ..its symptome for some systemic Pathopbysiogy. Pl.
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Sub maximum dose of anti hypertensive meds achieve BP control with few side effects! CCB- cilnidipin 10 mg/ amlodipin 5 mg od morning ARB- telmisartan 40 mg od night Diuretics- chlorthelidone 12.5 mg od morning But routine lab Ix is mandatory . CBC Lipids Creatinine RBS- FBS/PP2BS Thyroid function test Electrolytes Urinalysis ECG ECHOCARDIO
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She is an ideal candidate for two drug regimen - Telmisartan 40 mg + cilnidepine 10 mg .and Etizolam 0.5 mg bed time to relieve anxiety Monitor B.P regularly. If B.P is still not controlled tab chlorthalidone 6.25 or 12.5 as per the B.P levels can be added
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Nitroglycerin infusion, diuretics as it seem to be hypertensive failure
TREATMENT OF HTN ---------------------------------- Below 55 yrs 1 st choice ACE I / ARB if not controlled = add a CCB still not controlled = add chlorthalinedone Betablocker is a 4 th group of drug Age above 55 yrs 1 st choice a CCB IF INTOLERANCE / CONTRAINDICATED A ARB / ACE I IF CCB = 1ST CHOICE THEN 2ND CHOICE IS ARB / ACE 3 RD CHOICE = CHLORTHALIDONE 4 TH CHOICE BETABLOCKER IF STILL NOT CONTROLLED CENTRALLY ACTING DRUG IN CKD = ARB / ACE TO BE AVOIDED DM WITH HTN = ACE / ARB DELAYS / STOPS PROTEINURIA& NEPHROPATHY SPIROLACTONE = ALSO DIMINISH PROTEINAEMIA IN CKD = TO AVOID THIS DRUG
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First do some routein blood test S electrolytes HbA1C RFT Urine rm ECG xray chest PA Lipid profile Thyroid profile Start Tab Cetanil T 5/40 Tab Clonafit MD .5 Hs Cap Flunil 20 od
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