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Yes it is in fact recommended that he lower the dosages as advised by his doctor in view of the postural hypotension. With diabetes his treatment goal should be to maintain the blood pressure less than 140/90 mm Hg.
Generally patients having an isolated increase in systolic blood pressure means a relative intravascular volume overload. This is the reason for the sensitivity that these patients have to diuretic therapy, even at low doses (ie, 12.5 mg hydrochlorothiazide or less). Therefore instead of lowering the metoprolol I would advice you to consult with his doctor about whether you can lower the dosage of hydrochlorothiazide or even discontinue it. Metoprolol is less likely to cause postural hypotension when compared to diuretics. Metoprolol may lower the heart rate.
So if he has been diagnosed with postural hypotension he will most likely benefit from lowering the diuretic medication and this should be done only after consulting his doctor.
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