? Isolated Systolic Hypertension

A 70 year old female known case of HTN presented to OPD with complaints of headache. Upon examination, her BP was - 135/68 mmHg 145/67mmHg Her previous recordings have been almost the same too. She is currenlty on Amlodipine 2.5mg from last few years. She has only one kidney and that too with a small calculus of 2mm without any symptoms anytime. Her Lipid profile is quite deranged attached too. For her deranged lipid profile, she was on - Tab Rosuvastatin 10 +Fenofibrate 160mg at night, Cap. Maxepa once daily, And uprise d3 60k once weekly 8weeks for her insufficient vit d3 levels Should I step up to amlodipine 5mg now?

1 Like

LikeAnswersShare

Start with ace inhibitor or arb or calcium channel blocker Lower the amount of salt in her diet Get to or stay at Health weight Excersie regularly

I think this reading of bp wont fit into isolated systolic hypertension. The systolic bp is more than 170 190 mm of hg in isolation systolic hypertension with normal diastolic reading. She can be controlled with a drug like indepamide 1.5 mg daily or prazosin 5 mg od an alfa blocker.she has severe hypertriglyceredemia.it is usually genetic hyper triglyceridemia. She need more dose of aniti lipid drugs Rosuvastatin 20 mg.and finofibrate 160mg.ofcourse strict dietic restrictions

70 year old with headache DD Amlodipine induced headache Tension/ migraine headaches Temporal arteritis Depression Ocular causes like glaucoma ,refractive errors . Need to check . Since her BP is under control with minimum dose of amlodipine, it can be stopped and patient's BP observed . If there is rise in BP on stopping amlodipine, she can be a started on Nebivolol 2.5 mg OD . With a single kidney ACEI and ARBs are contraindicated.

No continue same doses of amlodipine diastolic control main which is their Serum triglycerides & serum chloseterol with ldl high Increase dose of rosuvastatin fibrates add naicin omega 3 responsible for atherosclerosis so target 200 cholesterol 150 to100 triglycerides ldl30 this will bring down systolic reduce table salt

Common form of systolic hypertension after65 age add Chlorthaizide
0

Yes amlodipine 5 can be given Adv: low salt intake Or ARB also given

Amlodipine 5 mg can be given