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My 92-year-old mother has historically had low blood pressure. There have been a few times when it went very high. Not enough to warrant blood pressure medicine. In May there were some problems with her blood pressure fluctuating and it went pretty high a few times. Her doctor prescribed 5 mg. of lisinopril. Then she went back to her old pattern of very low blood pressure - very lightheaded and unsteady on her feet and asked to be reduced to 2.5 mg. Recently her blood pressure has been running very low - diastolic around 49. She cannot get in to see her doctor very soon, will only be talking to the nurse practitioner. I read that the low doses are given more for heart failure (no one has mentioned that to mom and I don't want to!!). I am wondering if the low doses are even given to lower the blood pressure or are only given for their protective effect. I know it would be better for her to see a heart specialist, but that would mean travelling to another city, which she does not really want to do, and I don't know how soon it would be before we could get an appointment.
Unfortunately, I was not present when the lisinopril was prescribed and no one asked the questions that should have been asked. And there are certain questions I don't want to ask in front of mother. She also thinks she is quite capable of asking anything that needs to be asked, but I know that ability is diminishing rapidly.
What questions need to be asked about how to manage her low blood pressure, or fluctuating blood pressure? Has anyone had better outcomes with a cardiologist vs. primary care physician?

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These are ALL questions for the MD. Your Mom is "of an age". Not a criticism as, so am I at 81. Your Mom has what we call "labile" blood pressure. Think up, down and all over the place. So do I, and it is the reason I measure my BP every single a.m. There is a medication I take (atenolol) that I take for rate control of Atrial fib, but that also lowers pressure. I cannot often take my A.M. dose because pressure is too low. Lowering it more puts me in danger of collapsing in the streets, so a no no. As an old RN I can't tell you how many patients entered our ER after collapse, having taken meds for BP high in MD office, but low at home, and having gone down for it.

Most medications that have ANY effect on the heart ALSO have an effect on the BP. USUALLY to lower it. As to the uses of Lisinopril, look it up and you will see ALL the uses of it as well as its side effects.

Your question as to whether any of us TAKE it, is irrelevant as any person's reaction to any drug is as individual as his or her own thumbprint, and our experience could be 1,000% happy with your mom still having a side effect, if you see what I mean.

As an old RN I recommend daily, even twice daily measurement with an EASY Omron BP and P machine on amazon, cheap at about 30.00 last I looked and SIMPLE to use. Keep a record for the doc who will LOVE that. Make certain in MD office with next visit that this machine measures somewhat close to the office one.

As to the word CHF, yes, Congestive Heart Failure sounds scary and CAN be, but in truth, mom can look on this as an OLD PUMP that isn't as efficient as once it was, easy to understand at her advanced age. Is inevitable for ALL of us that our organs will age with time.

Sure wish you the best of luck.
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Ask the NP to give you guidelines. At what reading do we hold the Med. Is the question. I would ask that over the phone today.
Yes, a cardiologist appointment would be better than a primary for heart issues.
Get the appointment scheduled and see how she does between now and then. Keep the daily record of moms BP as Alva suggested to show the doc when you have the appointment.
My mom saw her cardiologist once a year to avoid the three hour trip. They worked well with home health for making any adjustments needed in medication w/o an in person visit.
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My dad took a low dose but, he had to have his BP checked every morning and depending on the readings, he got his medication or not. This was all set up through his cardiologist and it worked really well, he never passed out from low BP brought on by his medication.

Sometimes we have to look at the repercussions of taking a medication vs not taking it. Occasional high BP is less dangerous then hitting the floor because the meds make it to low.

Personally, I would try a low dose potassium supplement to see if that helps stabilize her BP a bit, because low potassium affects our BP big time.

Best of luck getting this sorted out.
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My Mom is, but when she was taking Lasix for her foot/leg swelling, she was advised to stop because of how it interacted with the Lisinipril. She typically has high blood pressure and it controlled it, but she also has CHF and trying to balance the effects of that with the medication was challenging for us both. She's in a SNF now, so they're in charge of all that. I take it as well, but my blood pressure is always on the low side.
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