Patient's Query
Hello doctor,
I am a doctor and want to get my father's opinion. A 70-year-old man with a history of diabetes and an acute MI (myocardial infarction) episode five years ago. He has been on medications since then. This is the current prescription he is following: a tablet of Metoprolol 25 mg twice a day.Aspirin/Clopidogrel 81/75 mg once daily, tablet. Atorvastatin 10 mg once daily, Captopril 12.5 % twice a day, Metformin 500 mg once daily, and Gliclazide 20 mg once daily.
His blood pressure has been constant at 110/70 mmHg for the previous five years on this regimen, but it is currently 140/68 mmHg. I also raised his Captopril to 50 mg three times daily, but there has been no change, and his blood pressure ranges between 130-145/60-70 mmHg. What exactly are our options to control it?
Kindly help.
Hello,
Welcome to icliniq.com.
Captopril is okay, but I prefer long-acting drugs like the tablet Lisinopril (ACE inhibitor) or Valsartan (angiotensin receptor blocker) once daily. Please check his EF (ejection fraction) in echo. If it is less than 40 %, Sacubitril or Valsartan tablets (antihypertensive) are good choices regarding blood pressure and mortality benefits. If it is above 40 %, then switch to a tablet. Lisinopril 10 mg plus or tablet Amlodipine 10 mg (calcium channel blocker) once daily. He can continue the tablet Captopril three times a day and add tablet Amlodipine 10 mg once a day. Check RFTs (renal function test) and electrolytes, and maintain a low sodium diet.
I hope this helps.
Thank you.
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Answered byDr. Muhammad Zohaib Siddiq
Medically reviewed byiCliniq medical review team
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