Vertigo, Hypertension

50 yr old female came with Vertigo for 1 day. No other symptoms,No comorbidities,Not on any medication.No systemic compilations. History of pregnancy induced Hypertension. History of hypertensive emergency in the past ,where she had blurring of vision.,for which she was given antihypertensives for 10 days...after that she stopped the medication. O/E: PR=78 bpm BP=172/92 mmHg.......after 10 minutes..... 158/98mmHg. Please elaborate an action plan. (Also please comment on giving Nicardia(Nifedipine) for instantaneous control of high BP.)

Need to find out cause of vertigo . If it is due to chronic hypertension, is it due to atherosclerotic vertebrobasilar insufficiency,? If peripheral labyrinthine signs are seen, it may be BPPV . Need to check for hypercholesterolemia. Amlodipine and nifidipine can quickly bring down BP in emergency situations. Long term control of BP is better with ARB+ BETABLOCKER combination , along with statins and aspirin . PT needs ENT check Betahistin will give good relief from vertigo.
Thank you very much sir
She is a c/o hypertension Took it lightly and dropped out Present bp is also suggestive of hypertension Hence needs to put on antihypertensives Preferably tab telmisartan+chlorthalidone And add ecosprin 150mg 1od If not improved r/o other causes like BPVV You can add betahistamine 16mg tds and see the response Adv investigations Ecg 2decho MRI brain Lab workout
Thanks a lot sir

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Start two drug regimes and ask for X-RAY CERVICAL Spine AP and Lateral view
Thank you sir
Below age 55 arb/acei are drug of choice
Tab temisartan 40 1 od
May I know your opinion about administering Amlodipine 5mg?

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Evaluate clinically the cause of vertigo.. Here probable cause may be hypertension.. Can give amlodepin 5mg.. Have regular check up for bp.. Do basis investigation i/v/o age around 50..