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High Blood Pressure

Labile Blood Pressure (Hypertension)

01/22/2008

Question:

My husband, age 83, has widely fluctuating blood pressure. It fluctuates between 90 systolic to 263 systolic during a typical day. He is on medication, but his pressure is not controlled. He had a 24 hour urine test which came back normal. His meds are fosinopril sodium 10mgs. 2x day, metoprolol tartrate 25 mgs. 2x day, clonidine HCL .1 mg 3x day, and nifedipine 10 mg. 3x day. His weight is 220 and he is about 5`7" tall. What could be causing these wide readings?

Answer:

He probably needs to be seen by a hypertension expert. If his blood pressure fluctuates that much, it carries significant risk. One possibility is that two of medications listed (clonidine and nifedipine) are very short acting but at their peak concentration in the blood are extremely potent in lowering blood pressure.

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Response by:

Jackson T Wright, MD, PhD, FACP Jackson T Wright, MD, PhD, FACP
Professor of Medicine
School of Medicine
Case Western Reserve University