Q: I am 60 years old. My height is 5ft 8 inches,my weight is 80 kg. My BP is 150/104. After taking 25mg Betaloc for a week it now stands at 150\100. Is it OK. Also when is the right time to take the BP tablet?

A:There are several points that need to be kept in mind:1. I hope you are already taking low-salt low-fat diet, doing brisk walk for atleast 45 minutes to cover no less than 4.5km daily. 2. Weight reduction by about 7kg to 10kg will give you lot of benefit and in fact may remove the need for drug therapy in due course.3. Betaloc is not the name of medicine but a brand name. It contains a medicine called metoprolol and belongs to a group of drugs called beta-blockers. The normal dose of metoprolol is 50 to 100mg twice daily (i.e. 100 to 200mg per day). You are taking 25mg in a single dose that is unlikely to produce desired effect. In fact your BP has not improved. There is not much difference between pre-treatment and post-treatment figures. A difference of 4mm in diastolic pressure can be due to fluctuation and/or recording error. In any case your diastolic BP must be brought down to 94mm or less. An agent belonging to beta-blockers is a good choice though these days we prefer atenolol (Brand names: Atecard, Tensimin). A dose of 50mg taken just once daily for 7-10 days should bring down the BP to desired level. If not the dose can be increased to 100mg taken just once daily. In case the BP is still not adequately controlled, a diuretic (e.g. chlorthalidone 12.5mg) can be added to 50mg of atenolol. (Brand name: Atecard-D).