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How to best manage hypertension?

Q: I am a hypertensive aged 45 years. I am on Amlopress AT 25 (morning & evening) plus Losacar H once a day (afternoon). In March 2003, my lipid profile was: -Serum Cholesterol 145mg/dl -TG 125mg/dl -HDL 37mg/dl -LDL 83mg/dl -VLDL 25mg/dl -LDL/HDL 2.24 -Chol/HDL ratio 3.91. The doctor advised me to take Atrovastatin TG TOR 20 once a day. At the end of three months, the lipid profile showed: -Serum Cholestrol 120mg/dl -TG 112mg/dl -HDL 29mg/dl -LDL 69mg/dl -VLDL 22mg/dl -LDL/HDL 2.37 -Chol/HDL ratio 4.13. My doctor advised me to take TG TOR 5mg and NIALEP 500 one tablet for 10 days and then twice daily for 2 days. Recently the lipid profile was repeated: -Total lipids 351 -Serum Cholestrol 100mg/dl -HDL 35mg/dl -TG 75mg/dl LDL 47mg/dl The rest showed no change from the previous value. Presently, I have discontinued the tablets of Nialep or TG TOR 5. I go for a 60 minutes brisk walk and my weight is 105kg. I am taking a diet of 1200 calories. I have no other problems as my TMT, 2D echo and all other tests were normal. As far as my lipids are concerned, kindly suggest the medicine which can maintain the present level (if you think it is ideal) and also increase the HDL. I would appreciate if you send my query to Dr U Kaul of Batra Hospital.

A:I think you are doing very well. I would like you to take both Nialip and TG TOR in the same dose. All hypertensives should be on lipid lowering drugs and also aspirin which you are not taking (50 mgs would do). These medicines are for a long long period and go a long way in preventing stroke, heart attack and kidney problems. Continue exercises and low fat-low salt diet.


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