AboutDomenic Sica Expertise All aspects of hypertension as well as any consideration in drug therapy for the management
of hypertension.
Experience Heavily published in the area of drug therapy in hypertension and renal disease. Primary management physician for a large multi-state referral practice for diagnosis and management of complex hypertension
Organizations Multiple including the American Society of Hypertension, International Society of Hypertension, American Society of Nephrology, American Heart Association, American College of Clinical Pharmacology amongst others.
Publications Over 250 publications (see PubMed)
Education/Credentials Board certified in internal medicine, nephrology, clinical pharmacology, and hypertension
Awards and Honors Multiple awards as clinical and/or teacher of the year.
Question QUESTION: I'm male, 63 years old. Runner-40 miles a week. Resting hr of 44bpm, high hdl, low LDL. Dr says Am in great shape. Do take benicar 20mg for bp. Also take niravam when needed - kind of an anxious person. I still notice my bp still spikes some once in awhile. When anxious it might go to 180/78. It later goes back to normal. Doesn't happen every day.. Just once in awhile. Of course when it gets high I tend to focus on it-makes it worse. Dr say spikes are normal and not to worry unless it stays high for days at a time. Do you agree? And should I use my niravam more often when worried? Thanks
ANSWER: Yes, I agree that the spikes themselves are not necessarily dangerous. It is likely that the spikes would respond to Nirvam if taken at the time of the spike. Whether you need to take it more regularly even without blood pressure spikes probably relates to how anxious you are throughout the day.
Regards,
Domenic Sica, M.D.
---------- FOLLOW-UP ----------
QUESTION: Quick follow up....Is it common for to still have the spikes in blood pressure throughout the day even while on medication - in this case benicar? Was wondering if i should take 2 a day instead of one or maybe split the second one.....My dr. currently has me on only one 20mg a day....also, even though I get those "spikes" once in awhile, my bottom number is rarely if ever over 80.....that number is always good....it's the systolic that tends to rise....of course, like I've said, all numbers do eventually come down, usually in the evening when I'm reading or relaxing....*I actually get stressed about it as soon as i pick up the bp monitor - example, it might be 180/75 the first time i take it and then 10 minutes later it's down to 135/70....is that common that stressing about it could actually cause it to go up? Thanks again for your time
Answer Benicar is a good drug for general hypertension but does not have any specific attributes that make it special for spiking blood pressures. Yes, in certain patients stressing about blood pressure can make it go and sometimes substantially so. You need to talk with your doctor about the stress involved with the measurement process. Sometimes treating for stress solves the problem since it is the root cause of the spikes. Stress treatment can involve certain anxiety medications, counseling, or cognitive behavioral therapy based on which approach is taken.
