Managing High Blood Pressure: Concerns About Medication Changes

Medication Consultation

Hello Doctor, my father has recently been experiencing consistently high blood pressure and chest tightness.
He previously underwent cardiac catheterization and suspects a blockage, so an exercise electrocardiogram has been arranged.
The doctor has now recommended scheduling a vascular examination and has prescribed medication.
However, my father was previously taking 5mg of Amlodipine at another hospital, but he felt it did not significantly lower his blood pressure.
After a recent examination at a different hospital, the doctor prescribed 40mg of Amlohexal.
Is such a significant increase in dosage likely to cause side effects? Should my father continue taking the originally prescribed Amlodipine? Thank you in advance for your response.
🙏

90, 40~49 year old female. Ask Date: 2024/01/05

Dr. Liu Hongxiang reply Family Medicine

Hello Jolingchang,
Blood pressure control includes diet, exercise, lifestyle adjustments, and medication.
When adjusting antihypertensive medications, if there are no contraindications or side effects, the adjustments are based on the usual blood pressure readings.
Some individuals may achieve satisfactory blood pressure with half a pill, while others may require three or four different medications.
Therefore, the increase or decrease of blood pressure medications should be tailored to individual blood pressure variations and cannot be solely determined by the number of medications prescribed.
It is advisable to bring your regular blood pressure records to your outpatient appointment to discuss with your physician, which should lead to better blood pressure control and a reduction in side effects.

Wishing you physical and mental well-being.

Dr.
Liu Hongxiang

Reply Date: 2024/01/05

More Info

Managing high blood pressure (hypertension) is crucial for maintaining overall health, especially for individuals with a history of cardiovascular issues. Your father's situation raises several important considerations regarding medication changes, potential side effects, and the management of his blood pressure.

Firstly, it’s essential to understand that blood pressure medications can vary significantly in their effectiveness and side effects. The previous medication your father was taking, 脈優錠 (Prazosin), is an alpha-blocker that can help lower blood pressure but may not be effective for everyone. If he did not experience a noticeable reduction in blood pressure with this medication, it is reasonable for the new physician to consider a different medication, such as 雅脈 (Amlodipine), which is a calcium channel blocker. Amlodipine works by relaxing the blood vessels, allowing blood to flow more easily, and is often more effective in achieving significant blood pressure reduction.

Regarding the increase in dosage from 5 mg to 40 mg, it’s important to clarify that the dosages of different medications are not directly comparable. Amlodipine typically starts at a lower dose (usually around 2.5 mg to 5 mg) and can be increased based on the patient's response and tolerance. The 40 mg dose you mentioned may refer to a different medication or a misunderstanding, as Amlodipine is usually not prescribed at such a high dose. It’s crucial to confirm the exact medication and dosage with the prescribing physician.

As for potential side effects, all medications can have side effects, and these can vary from person to person. Common side effects of Amlodipine include swelling in the legs or ankles, flushing, and palpitations. If your father experiences any severe side effects or if his blood pressure remains uncontrolled, he should contact his healthcare provider immediately. It’s also worth noting that when changing medications, it may take some time for the body to adjust, and blood pressure readings may fluctuate during this period.

In terms of whether your father should continue with the original medication or switch to the new one, this decision should be made in consultation with his healthcare provider. If the new medication is deemed appropriate based on his current health status and blood pressure readings, it may be beneficial to give it a try. However, if he has concerns about the new medication or experiences side effects, he should discuss these with his doctor, who may consider adjusting the dosage or trying a different medication altogether.

Additionally, lifestyle modifications play a significant role in managing high blood pressure. Encouraging your father to maintain a healthy diet low in sodium, engage in regular physical activity, manage stress, and avoid smoking and excessive alcohol consumption can complement his medication regimen and improve his overall cardiovascular health.

Lastly, it’s important for your father to have regular follow-up appointments with his healthcare provider to monitor his blood pressure and adjust his treatment plan as necessary. Blood pressure management is often a dynamic process that requires ongoing assessment and adjustment based on individual response to treatment.

In summary, while the change in medication and dosage can be concerning, it is often necessary to find the most effective treatment for managing high blood pressure. Open communication with healthcare providers, adherence to prescribed medications, and lifestyle modifications are key components in effectively managing hypertension and reducing the risk of cardiovascular complications.

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