Patient: Mother has had hypertension for over 10 years and has atrial fibrillation. Now taking Betaloc (half a tablet in the morning and half in the evening), Boeotin, and Ambrovir, all in the morning. Also taking warfarin. The left atrium is enlarged. Blood pressure is well controlled during the day, but it rises in the evening around 5 pm. Should I add half a tablet of AbbVie or half a tablet of Boydin in the evening? Or should I add another medicine? Thank you, doctor. Yi Zhong, Department of Cardiovascular Medicine, Aerospace Central Hospital
Yi Zhong, Department of Cardiovascular Medicine, Beijing University Aerospace Clinical School.
My mother has had hypertension for more than 10 years and has atrial fibrillation. She is taking Betaloc (half a tablet in the morning and half a tablet in the evening), Povidone, and Ambrovir, all in the morning. Also taking warfarin. The left atrium is enlarged. Blood pressure is well controlled during the day, but it rises in the evening around 5 pm. Should I add half a tablet of AbbVie or half a tablet of Boydin in the evening? Or should I add another medicine? Thank you, doctor. Hello!
Patients with hypertension are prone to atrial fibrillation due to increased intra-atrial pressure, so blood pressure control is more important.
It is generally believed that: drugs such as angiotensin-converting enzyme inhibitors (e.g. Mono, Yashida) and angiotensin II receptor antagonists (e.g. Dextran, Ambrovir) have some effect in reducing the occurrence of atrial fibrillation. Therefore, hypertensive patients with atrial fibrillation should choose these antihypertensive drugs when possible.
Your mother’s nocturnal blood pressure is not well controlled, so she should use an antihypertensive drug with a longer half-life, such as Loxodren.
Please tell us about your mother’s blood pressure level, left atrial size, and ventricular rate (heart rate), and how long her history of atrial fibrillation is, whether it is paroxysmal or persistent.
Good luck!
Patient: Left atrial 51 MM, blood pressure 75-115 during the day: elevated after 6 pm: above 85-130. Persistent atrial fibrillation. It’s been more than 2 months since the onset of the disease. I have not used Ketorolone. Heart rate has not been specifically side by side, left ECG shows about 85.
Patient: If I want to take Loxodren, should I change that medication to Loxodren and still take it? Now taking another pill. Now eating betalactam, Ambovy, Cindapaxan, and Pogostat.
Yi Zhong, Department of Cardiovascular Medicine, Peking University School of Aerospace Clinical Medicine.
Oh, the left atrium is already on the large side.
Lopressor can lower the blood pressure steadily, so it should be more suitable for your mother than Boydin. However, it should be noted that the half-life of Loxodren is 36 hours long, so its effect (blood pressure can be steadily controlled) usually takes 7-10 days after the drug is used, so the blood pressure will be slightly high in the first few days of taking the drug, but it will be fine after a week or so.
It is recommended that you choose Loxopro 10mg (morning) + Dextran 80mg (afternoon) as your antihypertensive medication.
In addition, you can also take: 100mg of Bayer aspirin every morning after meals (if you have peptic ulcers, you can use “Burkitt” instead).
Check blood pressure and heart rate control in about half a month (you can bring an ECG)
Happy New Year!