Q: I am 41 years old and have high blood pressure from the last 10 years. My doctor advised me to take Atenolol 25 g initially, but from the last 3 years, I am taking 50 g of the same every morning. As per my doctor, my BP is directly related to anxiety. I have a construction company and look after my own business. Recently I went to another doctor, who advised to stop Atenolol and switch to a better medicine. He prescribed Nicardia, and then changed to Losar 50, and now Nebicard 5. The reason for changing these medicines was that they were not suiting me. After taking these medicines I am experiencing many side effects like dizziness, joint pains, swelling of eyes, etc. Can I continue with Atenolol 50? Is there a medicine, which does not having any side effects? I have severe acidity, due to not taking food at correct time. I take alcohol twice or thrice a week and smoke 5 cigarettes per day. Please advise.

A:Hypertension is the technical name of high blood pressure. In the last couple of years, the treatment of high blood pressure has undergone major changes. As per globally accepted, evidence based guidelines, for patients younger than 55 years, first choice initial therapy should be an ACE inhibitor such as enalapril 5-10mg, 1-2 times daily (sold under the trade name of BQL, Enam etc). It is particularly suited to sexually active males. In cases where enalapril is not tolerated (some patients get persistent cough), losartan (sold under the trade name of Losacar) 50mg daily can be used. If two drugs are required, then add a diuretic such as metolazone 2.5mg (sold under the trade name of Metoz). For all patients if treatment with three drugs is required, the combination of enalapril or losartan + amlodipine (sold under the trade name of Amlodac) and a diuretic such as Metoz should be used. Atenolol and nebivolol (Nebicard) are similar agents and are not recommended because they perform less well than other drugs and the increasing evidence that they carry an unacceptable risk of provoking diabetes. Besides, they can cause impotence. You need to give up smoking because it has adverse effect on high blood pressure and heart. Alcohol up to 2 units* twice a week is not a problem. With regard to anxiety, one should use non-drug stress relieving methods such as Yoga. Use of anti-anxiety medicines leads to addiction and side effects. * Note from DoctorNDTV: Alcohol units is a simple way to measure how much alcohol you are drinking, and some drinks now say how many units they contain. A unit of alcohol is said to be equivalent to half a pint (roughly 250ml) of standard-strength beer, one measure of spirit (25ml of 40% strength hard liquor) or one glass (125 ml) of wine.