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How to manage high BP as a result of stress?

Q: I am a 31 year old lady, unmarried and in Bangalore. I have high blood pressure systolic varying between 160 and 170mm Hg and diastolic always 110mm Hg(*). I think I am on high medication already. I do exercise and take care of my diet. It has been 110mm for a few months now. I am on Minipress XL(5mg) twice a day and Losar(50mg) twice a day for a month now. I am not worried about the systolic pressure but about why the diastolic pressure is not coming down. My doctor has asked me to take one more tablet of Minipress XL(5 mg) and Losar(50 mg) in addition to what I am already having. I do not want to have this extra dosage as I feel the medication is already high and it makes me weak if I increase the dosage. What should I do? Should I follow my doctors advice or can I let the BP continue to be at 170/110? My eyes have some kind of involuntary movement (slight) and most of the time they appear to be red. The other medicines I am on are for hypothyroidism - Thyronorm 50mg and for Obsessive Compulsive disorder and depression - Flunil 60mg (twice a day), Narebox - 4mg (3 in a day) & Qutipin - 150mg (once at night). I have been having the above medicines for quite a few months and there is improvement in my psychiatric condition because of them. Is it safe for me to continue the above medicines? I am consulting my psychiatrist regularly and also getting all the tests done like Master Health Check up, random cortisol level, TSH (for thyroid problem), ultrasound scan of abdomen and pelvis and 24h urinary VMA TEST. I am fed up of taking medicines, besides they are so expensive. And I also have some personal problems right now, financial and domestic. What should I do about my HIGH BP and other problems? Which doctor should I consult now (which specialist?)? I am so worked up all the time.

A:For your hypertension you should consult a physician ie MD Medicine. You should always follow your doctors advice regarding medicines because sometimes one does need high doses to control symptoms. Otherwise it would be bad for your kidney, heart, eyes, brain and other organs. Once the BP is controlled, he would certainly start tapering your medicines after sometime. You can meanwhile convey your fears and side effects to your doctor so that he can make necessary adjustments in drugs. Stress is a factor which does effect BP So do try to manage it by sorting out your personal problems and following relaxation techniques like meditation, yoga etc. If still your BP is not controlled you can go to a superspecialist-a nephrologist or a cardiologist. Continue regular follow up with your psychiatrist and do inform both your doctors about each others prescription.

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