Managing High Blood Pressure in Elderly Patients with Shingles

Q: Managing High Blood Pressure in Elderly Patients with Shingles

Hello： Daily blood pressure can fluctuate based on physical condition; activities, emotional changes, and discomfort can all lead to elevated blood pressure, which is a normal physiological response. <br>Therefore, higher blood pressure during illness does not necessarily require

After taking 160 mg of De-An-Wen and 5 mg of Mai-You, my blood pressure still won't come down?

Hello Doctor, my mother is 88 years old and has recently developed shingles on her face and head (she is still experiencing symptoms).
Her blood pressure has skyrocketed.
I have her taking 160 mg of Amlodipine and 5 mg of Bisoprolol, but her blood pressure is still 166/103.
Can I give her another 160 mg of Amlodipine? Or can I give her another 5 mg of Bisoprolol? Or do you have any other better suggestions? Thank you!

Lin Xiansheng, 60~69 year old female. Ask Date: 2023/04/26

Dr. Huang Yinghe reply Cardiology

Hello: Daily blood pressure can fluctuate based on physical condition; activities, emotional changes, and discomfort can all lead to elevated blood pressure, which is a normal physiological response.
Therefore, higher blood pressure during illness does not necessarily require intentional lowering.
If elevated blood pressure is accompanied by related symptoms such as dizziness or palpitations, additional medication may be taken (up to a maximum of 10 mg of Prazosin per day, and up to 320 mg of Atenolol, although regular use is not recommended).
It is advised that if blood pressure remains high despite improvement in shingles, you should promptly return for a consultation with the physician managing your mother's blood pressure treatment.

Reply Date: 2023/04/26

More Info

Managing high blood pressure in elderly patients, especially those with concurrent health issues like shingles, requires a careful and nuanced approach. Your mother's situation, given her age and the presence of shingles, necessitates a thorough understanding of both her cardiovascular health and the implications of her current medications.

First, it’s important to recognize that shingles (herpes zoster) can cause significant stress and discomfort, which may contribute to elevated blood pressure. Stress, pain, and discomfort can lead to temporary spikes in blood pressure, and in elderly patients, this can be particularly concerning. Therefore, managing her pain and stress levels is crucial in controlling her blood pressure.

Regarding her current medication regimen, you mentioned that she is taking Amlodipine (脈優) and a medication referred to as "得安穩" (which I assume is a form of beta-blocker or another antihypertensive). The combination of these medications is generally effective for managing hypertension, but the dosage and frequency must be carefully monitored, especially in elderly patients who may have altered pharmacokinetics and pharmacodynamics.

1. Dosage Adjustments: Before considering increasing the dosage of her current medications, it’s essential to consult with her healthcare provider. Doubling the dose of Amlodipine or any other antihypertensive medication without medical supervision can lead to hypotension (low blood pressure), which can be dangerous, especially in an elderly patient. If her blood pressure remains high despite her current regimen, her doctor may consider adjusting her medications or adding another antihypertensive agent rather than simply increasing the dosage.

2. Monitoring Blood Pressure: Regular monitoring of her blood pressure is vital. If her readings consistently remain above the target range (generally below 130/80 mmHg for older adults, but this can vary based on individual health conditions), it may indicate that her current treatment is insufficient. However, it’s also important to consider her overall health status, including her response to shingles treatment and any other comorbidities she may have.

3. Alternative Medications: If her blood pressure continues to be elevated, her physician might consider adding another class of antihypertensive medication, such as an ACE inhibitor, ARB, or diuretic, depending on her overall health profile and kidney function. Each class of medication has different mechanisms of action and side effects, so the choice should be tailored to her specific needs.

4. Lifestyle Modifications: In addition to pharmacological treatment, lifestyle changes can also play a significant role in managing hypertension. Encouraging a heart-healthy diet (such as the DASH diet), regular physical activity (as tolerated), adequate hydration, and stress management techniques can be beneficial. Given her shingles diagnosis, ensuring she has adequate pain management and emotional support is also crucial.

5. Follow-Up Care: Regular follow-up appointments with her healthcare provider are essential to monitor her blood pressure and adjust her treatment plan as necessary. If she experiences any side effects from her medications or if her blood pressure remains uncontrolled, it’s important to communicate these issues to her doctor promptly.

In summary, while it may be tempting to increase her medication dosage in response to high blood pressure readings, it’s crucial to consult with her healthcare provider first. They can evaluate her overall health, consider the impact of shingles on her condition, and make informed decisions about her treatment plan. Managing hypertension in elderly patients requires a comprehensive approach that includes medication management, lifestyle modifications, and regular monitoring.

Similar Q&A

Supporting Elderly Recovery: Navigating Health Challenges After Illness

Hello, doctor. I would like to ask for advice regarding medical management for my grandfather, who is currently 97 years old. Two years ago, he experienced confusion upon waking up and had low blood pressure. After being taken to the hospital, he was diagnosed with ascites and su...

Dr. Cai Dongqi reply Family Medicine
Hello: 1. In elderly patients with fever and shortness of breath, the primary consideration is infection, especially pneumonia. If there are confirmed cases in the household, it is likely that the grandfather may also be infected (rapid testing at the emergency department may be ...

Managing Fluctuating Blood Pressure: A Guide for Seniors

Hello Doctor: My mother is 66 years old and has slightly elevated cholesterol, which she is managing with medication. Recent blood tests have been normal. Besides taking serotonin, she does not have any other diseases. However, she experiences low blood pressure every morning upo...

Dr. Wu Xueming reply Cardiology
Based on your mother's condition, it is recommended to visit the outpatient clinic for the physician to adjust her current medication.

Managing High Blood Pressure: Concerns and Remedies for Seniors

My mother has recently been experiencing stiffness and pain in the back of her neck, and upon checking her blood pressure, it was found to be over 150, whereas she previously had low blood pressure (around 60 to 80). This change may be related to her recent retirement and the inc...

Dr. Ye Boshou reply Neurology
Before deciding whether to take blood pressure medication, it is essential to monitor blood pressure over a long period to establish a baseline. Cardiologists recommend maintaining systolic blood pressure below 140 mmHg. Sudden drops in temperature can also affect blood pressure....

Managing Blood Pressure and Edema in a 76-Year-Old Patient

Hello Dr. Wu: My mother is 76 years old and has been taking Adalat 30 mg for many years. Recently, she has experienced edema in her lower extremities. We switched her to one Zanidip (Lercanidipine) 10 mg at bedtime and one Fluitran (Furosemide) 2 mg during the day. Although the l...

Dr. Xiao Yongxun reply Internal Medicine
Dear Miss Hsiao-Fen: 1. Your mother is taking Adalat® (30mg; generic name Nifedipine), which is a calcium channel blocker. Long-term use can lead to sodium and fluid retention, resulting in edema. It is recommended to switch to Zanidip® (10mg; generic name Lercanidipine) and Flu...