Sleep apnea, hypertension
My father 66 years diagnoised with bp 170/100 due to sleep disorder(shortness of breath during sleep), asthma since 2 yrs. He is using cpap since 1 year and results were not productive.medication started with sartel 40, cinod 10, rousuvas, forocot, montair. For few months bp was in control 130/80, 140/90. Over a period of time bp has increased and medications were corrected to morning: sartel 80, ivabard 5mg, ctd 6.25mg evening: sartel 80, ivabard 2.5mg, rousvas 10 in the night. results were little better but now bp is not getting controlled again.Morning at 6 he feels active, normal but after taking medicines he feels uncomfortable(dizziness, uneasy and elevated bp). Bp comes down at 1pm post lunch. he feels comfortable with night dosage.cpap reports showed AHI count is in control. I feel the quality of sleep is lagging for him he gets repeated cough with cpap machine and does not get a productive sleep(might be due to asthma or dry air of the machine which irritates him not sure).
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Points you should understand 1. Your father essentially is on only two BP drugs. Ivabrad doesn't reduce BP 2. In such cases of resistant hypertension, adding 3 or more drugs with different actions in moderate doses is better than using highest dose of one or two drugs. Sartel at a dose of 80 twice a day is quite high, could be causing morning weakness and dizziness 3. Why was Cinod stopped? Was it due to some side effect. I would have continued Cinod or another CCB from same group. 4. Sleep apnea and asthma are very different diseases. Need to reassess presence of sleep apnea. Get a humidifier for the CPAP machine so the air isn't cold and dry, which will otherwise precipitate asthma.
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