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 In March 09 I had an aortic valve replaced and a double by-pass. since then my blood pressure varies widely throughout the day,i.e. 100/45 and up to 195/90. My cardioogolist seems to be puzzled by this, can you tell me maybe whats going on?80y8h
Answer A couple of thoughts for you
1. Are the low blood pressure readings occurring in association with a low heart rate (< 60 beats/minute)?
2. Are the low blood pressures at a time when you had recently (within a couple of hours) taken blood pressure medications?
3. Are the low readings in the morning and the values go up as the day goes on in association with a weight gain during the day (2-pounds or more)?
4. Are your blood pressures any different when you are lying and standing?
How these questions are answered would provide some additional insight into your pattern.
