Medication Concerns in Neurology: Managing Blood Pressure After Stroke

Medication issues

Grandma had a stroke in the past, so she takes one tablet of Lipitor (5 mg/10 mg) daily.
Her blood pressure has been stable; however, during her follow-up appointment at the end of August, her systolic blood pressure was only in the 90s when measured at the hospital, prompting the physician to adjust her medication.
She has since been taking only half a tablet of Lipitor, but her blood pressure has recently been elevated, with a significant pulse pressure.
Her readings are 151/73 mmHg and 154/80 mmHg.
Should I consult the physician about resuming the full dose of Lipitor? (Her next appointment is not until the end of December, so I am asking Dr.
Peng for advice in advance.)

Da Mi, 40~49 year old female. Ask Date: 2022/12/05

Dr. Peng Shiwei reply Neurology

Hello, based on my assessment, it is possible to restore one of the fat veins.
However, I still recommend that you take your mother to her usual follow-up clinic for an earlier appointment, as it would be better for the original physician to make the evaluation.

Reply Date: 2022/12/05

More Info

Managing blood pressure after a stroke is a critical aspect of post-stroke care, particularly for elderly patients who may have multiple comorbidities. In your grandmother's case, her history of stroke necessitates careful monitoring and management of her blood pressure to prevent further cerebrovascular events.

The medication you mentioned, Lisinopril (脂脈優), is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat high blood pressure and heart failure. It can help protect the kidneys and reduce the risk of stroke. The fact that your grandmother was initially on a full dose of Lisinopril but had her dosage reduced due to low blood pressure readings (around 90 mmHg systolic) indicates that her healthcare provider was concerned about the potential for hypotension, which can be particularly dangerous in stroke patients.

However, the recent readings you provided—systolic pressures of 151 and 154 mmHg—indicate that her blood pressure has risen significantly since the dosage was reduced. This increase in blood pressure could be due to several factors, including changes in her overall health, medication adherence, dietary factors (such as salt intake), or even stress. It is essential to consider these factors when evaluating her blood pressure management.

Given that her blood pressure is now elevated, it may be reasonable to discuss with her healthcare provider the possibility of returning to the original dosage of Lisinopril. However, this decision should not be made without consulting her physician, as they will have the complete clinical picture, including her kidney function, electrolyte levels, and any other medications she may be taking. It is also important to monitor her blood pressure regularly to ensure that it remains within a safe range.

In addition to medication adjustments, lifestyle modifications can also play a significant role in managing blood pressure. Encouraging a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, and low-fat dairy while reducing saturated fat and cholesterol, can be beneficial. Regular physical activity, as tolerated, can also help lower blood pressure and improve overall cardiovascular health.

Moreover, it's crucial to monitor for any symptoms that may indicate worsening blood pressure control or other complications, such as headaches, dizziness, or changes in vision. If your grandmother experiences any concerning symptoms, it is essential to seek medical attention promptly.

In summary, while it may be appropriate to consider resuming the full dose of Lisinopril given her elevated blood pressure, this should be done under the guidance of her healthcare provider. Regular follow-up appointments are vital to ensure her blood pressure is managed effectively and to adjust her treatment plan as needed. Open communication with her healthcare team will help ensure that her medication regimen is tailored to her specific needs, balancing the risks of hypotension with the necessity of controlling her blood pressure to prevent further strokes.

Similar Q&A

Understanding Post-Stroke Symptoms and Management in Patients

Hello, Doctor: I would like to ask about my father, who is 58 years old and has high blood pressure. His blood pressure usually ranges from 150 to 160, and he has experienced dizziness for over ten years. In mid-March of this year, his blood pressure spiked significantly, and he ...

Dr. Jiang Junyi reply Neurology
Hello, based on your description, I would like to know if your father has a history of diabetes or any other medical conditions besides hypertension. The use of many medications can have related side effects, and if he has a unique constitution that makes him more sensitive to me...

Managing Hypertension: Concerns After Mild Stroke and Medication Adherence

Is hereditary hypertension associated with a mild stroke experienced in July-August? Could forgetting to take medication lead to fluctuating blood pressure? Additionally, is it possible to have slurred speech, memory decline, or reduced limb strength, along with prolonged sleep d...

Dr. Lin Changqi reply Cardiology
When discontinuing medication, there may be an increase in symptoms, but ongoing medication management can control this. Blood pressure may need to be lowered slightly, and it is advisable to consult both cardiology and neurology, as well as rehabilitation medicine, for comprehen...

Understanding Stroke: Managing Complications from High Blood Pressure

Hello, Doctor! My mother has a history of hypertension and was recently hospitalized due to extremely high blood pressure. The examination results indicated vascular blockage in her brain, with both old and new blockages present. When we inquired about the cause, the examining ph...

Dr. Ye Boshou reply Neurology
The situation you described is somewhat complex; it appears to be multiple cerebral strokes with newly formed blood clots. It is unclear where the bleeding is located. I recommend discussing this with the attending physician to understand the condition better (family members have...

Managing Blood Pressure After Brain Hemorrhage: Key Concerns

Hello Doctor, my mother underwent successful surgery for a hemorrhagic stroke (left hemisphere) in early March of this year and is currently undergoing active rehabilitation (her recovery is going well). She is also taking the prescribed medications, including antihypertensives, ...

Dr. Cai Zongzhang reply Neurology
Hello: It is recommended to continuously record your morning and evening blood pressure readings and discuss the dosage and timing of antihypertensive medications with your physician.