AboutDr. Shabbir Baldiwala Expertise I can answer questions pertaining to maintenance of optimum blood pressure control, drugs to be used in different clinical settings, precautions and side effects to watch out for while using these drugs. Hypertension is the single largest killer disease affecting all organ systems.
Experience 5 years of training and 8 years of Clinical Practice.
Question I am 5o years male on hypertension treatment Atenolol 100 and Losartan 100. Attorvastatin 10 mg Folvite 5 mg B12 500 MCG. I am suggested Aspirin 150 as prophylaxis. I am ex asthamatic ( Since last 5 years, except once or twice, I have notasthamatic bouts) My PFT is normal. I am overweight. Non diabetic Non smoker Non tobacoo chewer. Family history positibe for HBP and negative for IHD. I am overweight. My TMT negative : 2D Echo says 65% EF : LVH : Normal LV systolic and diastolic function. I have Homcystein level at 18 Lp(a) 55. High Uric Acid level on Zyloric 100 twice Now it is 3. I have following queries.
1, I have Mild Antral gastritis and Duodenitis of bulb, Internist has suggested Tab Clopidogrel-75 in stead of Aspirin-150. Is the suggested change desirable.
2, My HDL is 35, What should be done to increase HDL Levels. My lipid level is otherwise normal range.
3. My PFT is normal. I have only seasonal asthmatic Bronchitis. Internist says I need to stop Amlopress AT and suggested Diltiazem 120 daily. I have occasional Ventricular Ectopia eith Techcardia. Since 1989, I am on Betacard 50. In 2000, Norvasc 10 added and from 2002, I am on Atenolol 100 and Norvasc 10 . I am not comfortable with Diltiazem 120. Atenolol +Norvasc+losartan suits very much. My internist is against this in view of past history of asthama. In fact, he writes in his prescription that "atenolol is contra indicated due to asthama" and taking it against medical advice What should I do. I consulted cardiologist who opined that stopping Atenolol by me would not be prudent from cardiac point of view. I am in dilemma.
Above queries are not raised for dignostic purpose nor for any specific treatment. But I see from answers on various diseases that you are rendering selfless educational service. I thought to have final word in my case because yours is very true and honest advices without any professional approach. Thanks and eagerly waiting for your advices.
Answer 1. Clopidogrel may be preferred instead of Aspirin
2. Exercising regularly is the only way to increase your HDL. Not to worry too much since your other lipids are normal.
3. Since your asthma is a mild seasonal variant, you can continue with the same anti-hypertensive combination.
