ACD of blood pressure treatment

Patient

Q: Dear Doctor, I am an Indian (Asian) and hypertensive for the past 40yrs and so far no anti-hypertensive drug kept my BP normal or near normal. Recently I was on beta blocker, but another doctor withdraw atenol as it may cause side effects like rised blood sugar (caused in me).my BP was always 160 70mmHg. My present doctor said that it may be systolic hypertension and gave me Amlodipin 5mg for the past 2 days. now my BP is 147 64mmHg. is it good reading?how long it would take me to get normal BP?am i on right medication with systolic hypertension?is there any advanced treatment?please write me.I am 65yrs old male,Indian with modereate activity with no complications or disease other than Systolic HT and slight rised blood sugar.Thank you.

Doctor

A:   Hypertension treatment guidelines follow the ACD rule. In someone of your age, initial therapy could be with either a Calcium channel blocker (amlodipine) or Diuretic (Hydrochlorothiazide). The maximum dose of Amlodipine is 10mg/day; therefore this may be increased to control your blood pressure further. Beta-blockers are no longer first line but may be used as additional therapy usually if a patient has angina, history of previous heart attack or heart failure. Target blood pressure for the general population is <140/90mmHg, but if you are diabetic the target blood pressure is reduced to <130/80mmHg. I would recommend discussing these options with your family doctor, in addition to lifestyle modifications.

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