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Do I need drugs for high blood pressure?

Dr Chandra M Gulhati
Editor, MIMS,
New Delhi

Q: I am 41 years old male. In my regular check-up it was found that my cholesterol level is high and blood pressure was 136/86. Doctor advised me to take Razel 10 in the morning and Perigard 2 in night. I am taking these from the last three months. I had a hypertension problem earlier for which I used to take occasionally Trika .25 at night occasionally. If I take Trika along with the above mentioned tablets, will there be any problem? Will Razel, Perigard, Trika conflict with each other?

A:Your blood pressure of 136/86 is not high and hence no medication is necessary. If at all it goes beyond 140/90, one should first attempt to control BP by non-drug means i.e. exercise (brisk walk of at least 4.5 km in no more than 45 minutes daily), low fat and low salt intake. One should be prescribed medicines (all have side effects) to young adults only when non-drug methods have failed.Since you have not given the cholesterol levels, I am unable to comment on whether or not you need medication. Assuming that you do need medicine, one should certainly avoid rosuvastatin (sold under various brand names such as Razel) since it has caused severe adverse effects including rhabdomyolysis (a potentially fatal disorder of muscles). This medicine is known to have more serious side effects in Asian ethnic groups (such as Indians) compared to Caucasians (such as English, Anglo-Saxons). Because of this reason the US Government agency dealing with medicines has ordered the manufacturers to conduct further trials on this drug in Asian communities.Older statins such as atorvastatin (sold under various brand names like Atorva, Liporest) or lovastatin (sold under the brand name of Pro-HDL) are safer and as effective in reducing cholesterol levels.It will be in your own interest to give up alprazolam (sold under various trade names such as Trika) since it is not meant for high BP but is an anxiety-suppressor. Its long term use will lead to addiction and will create more problems and solve none. For this reason is approved for use only for very short terms in psychiatry.