Expert: Dr. Shabbir Baldiwala - 6/23/2009

Question
QUESTION: I am 54 years male and hypertensive I was taking Amlopress NB ( Nebiovolol 5 + Amlodepine 5 mg ) and Tazloc H while I was under the treatment of internist.

But my new dr at new place changed it to Amlovas L ( Amlodepine 5 mg + Lisinopril 5 mg ) and Lostatin 20 mg. which I have been taking since year. I have been taking medicines since long. I had a health check up recently at SRL Lab where the  readings are CHOLESTROL- 215 TRIYGLECERIDE 165 HDL 51 LDL 149  VLDL 33. My Fasting Blood sugar is 112 and SGPT 91 Hemoglobin 17.8 Hematocrit 51.6  SGOT 76 Creainine 0.7 Uric Acid 5.4 . My question is why my lipids are high when I am taking Lovastatin 20 mg. I am alchoholic  and overweight. Kindly suggest and guide me why my reports are abnormal and whether any drus are to be added or deleted so that I can take up with my internist. Thanx and regards

ANSWER: Your Lovastatin is probably insufficient to control your lipid levels. You can substitute it with Atorvastatin+Ezetimibe. Your SGPT is raised since you are an alcoholic. Do you smoke frequently? You havent mentioned your pressure reading.

---------- FOLLOW-UP ----------

QUESTION: I have a habit of smoking 6 to 7 cigarettes and 1o bidis. I occassionally take non veg also I have a sedantary life style. I started taking amlovas L once when my BP detected but last year my new dr changed to Amlopress NB night and Tazloc H. But when I met my old dr he changes it to amlovas L . Bp is around 150/100 in the evening. I would loike to know which bp drugs are ok  for me.

Answer
You have to stop smoking with immediate effect. You are at a very high risk for developing a cardiac problem. You have high lipids despite taking statins, your Hemoglobin is raised which can also slow down your circulation, your hypertension which is a silent killer, is poorly controlled and to top it all, you have a sedentary lifestyle. Continue with Amlopress-NB and Tazloc-H and take good care of your health.