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My mother is on bp medication. her bp is very high in the…

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Hello, my mother is...

Hello, my mother is on bp medication. her bp is very high in the morning 190/70 . She takes micardis/hcl 80mg and her doc added hydralizine 25mg to take at night. her bp in the evening is 160/68 and she is leary about taking the hydralizine. It appears as its isolated systolic issue but not sure how to get that down without lowering the diastolic.

Doctor's Assistant: When was last time you had a check up? Is there a history of high blood pressure in your family?

I think her grandmother had high bp.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

She takes prednisone for myasthenia gravis and ivig every 8 weeks for the MG. ok thank you

Submitted: 7 months ago.Category: Medical
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Answered in 3 minutes by:
12/19/2017
Doctor: Dr. Phil, MD, Medical Doctor replied 7 months ago
Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 59,694
Experience: Medical Doctor Trained at a Top Academic Institution
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Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

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Doctor: Dr. Phil, MD, Medical Doctor replied 7 months ago

Usually high morning blood pressure indicates sleep apnea.

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Customer reply replied 7 months ago
Should she still take the hydralazine at night?
Doctor: Dr. Phil, MD, Medical Doctor replied 7 months ago

No she needs tested for sleep apnea

that is the proper treatment for this

I'm sorry this is happening

I'm sure it is stressful for you all

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Customer reply replied 7 months ago
thats usually treated with a cpap?
Doctor: Dr. Phil, MD, Medical Doctor replied 7 months ago

Yes, it is

let me know if you have other questions.

if done for now, please leave a 5 star rating above the chat box so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me with "a question for Dr. Phil" in the medicine, cardiology or pharmacy categories if you have any other questions

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Doctor: Dr. David, Board Certified Physician replied 7 months ago
Dr. David
Dr. David, Board Certified Physician
Category: Medical
Satisfied Customers: 49,915
Experience: Experienced Physician trained in New York City. I'm ready to help.
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This is Dr. David

you seem to have opted out the other expert.

did you have other questions ?

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Customer reply replied 7 months ago
Just thought I would get some more information other than maybe sleep apnea ?
Customer reply replied 7 months ago
Maybe different tx strategy regarding her no meds? Other testing ? Other dosing ?
Customer reply replied 7 months ago
B p. Not no
Customer reply replied 7 months ago
I was on this site before and spoke in depth with another dr.
Doctor: Dr. David, Board Certified Physician replied 7 months ago

it may not be sleep apnea.

sleep apnea can cause snorning and disrupted sleep.

how old is she?

is she able to exercise?

is she able to cut down on her salt intake?

is she overweight?

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Customer reply replied 7 months ago
71. Has myasthenia Gravis. Is not overweight. Eats very healthy. Takes mg prednison daily. Bp fine at night. Only high in am.
Customer reply replied 7 months ago
How do you treat isolated systolic blood pressure issues. Diastolic is always fine
Doctor: Dr. David, Board Certified Physician replied 7 months ago

I see

when does she take her prednisone?

prednisone should be taken first thing in the morning after a meal as her body's steroids are naturallly highest in the morning.

there is no way to just treat high systolic

more blood pressure medications can be used.

like clonidine, or lisinopril

these will not bring down her diastolic pressures much.

it could be her taking her prednisone, and when she makes her own body's steroids in the morning, this could be causing high blood pressure in the morning.

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Customer reply replied 7 months ago
She takes it in the morning. The doctor added hydralazine 25 Mg at night. But it was 160 over 65 this evening and we didn't know whether she should take it. It has been keeping it lower in the morning but is that to low of a number to take it at night ? She takes her micardis hct in the morning
Doctor: Dr. David, Board Certified Physician replied 7 months ago

the hydralazine will not bring down her diastolic to dangerous levels.

that is not a worry.

if the hydralazine is working, that is fine.

it can help her sleep at night and can help decrease some anxiety symptoms as well. it is safe to use daily

it is very similar to benadryl.

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Customer reply replied 7 months ago
Ok thank you!!!!!
Doctor: Dr. David, Board Certified Physician replied 7 months ago

Let me know if you have other questions.
If done for now, please leave Positive Rating of 5 Stars so I can get credit for helping you today.
We only get credit for helping clients after positive feedback. (You may have to scroll up or down to see the ratings area)
You can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions.
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Customer reply replied 7 months ago
you don't think 160 over 60 is too low to take the hydralazine ?
Doctor: Dr. David, Board Certified Physician replied 7 months ago

no, she can take the hydrazalzine.

Let me know if you have other questions.
If done for now, please leave Positive Rating of 5 Stars so I can get credit for helping you today.
We only get credit for helping clients after positive feedback. (You may have to scroll up or down to see the ratings area)
You can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions.
Here is my website if you need to reach me:
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