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Why are drugs I am taking for hypertension not effective?

Q: I am suffering with high blood pressure from the last five years. Medicines are not responding properly. Now I take three medicines: Minipress exe 15 mg, concer 5mg and Listril 5mg. Now my BP is 140/100. My age is 41 years, sugar is normal (fasting 80 and PP 100). Uric acid 8.5. I take zyloric 100 mg also. Please advise.

A:For your age, you are apparently taking too many medicines without adequate response. As per Evidence-Based Medicine, it is always better to start with a diuretic and then add second medicine if at all required. It appears that due to your high uric acid, a diuretic is not being given. While one should avoid a certain type of diuretic (called thiazide), there is little problem if another kind such as indapamide is used. The advantage with indapamide (Brand name: Indicontin Continus) is that it is taken in very low dose (1.5 mg) and acts for 24-hours. One tablet a day in the morning is the usual dose. If at all a second medicine is required, it should invariably be a member of the ACE inhibitor group, particularly in young, sexually active patients. Initially enalapril 10 mg (such as BQL by Cadila Healthcare) once daily is the drug of choice. It can be increased to 10 mg twice daily if required. In your case, I do not think you will need a third drug.

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