Conversation: The conversation between human and AI assistant.
[|Human|] Hi im a 53 yr old male was taking enalapril 10mg bid for months. BP was manageable. 9 days ago at my 3mo follow up my bp went from 134/90 to 177/120. My doctor increased it to 20mg bid. My pressure stayed the same for nine days until I went to VA emergency. they gave me 3 25mg metoprolol over a 3hr period. My pulse was120 also. My pulse came down to 88 but my bp only to 164/118. So they ran ekg no problem sent me home with metprolol 100mg bid with enalapril 20mg bid. I took one of each when I got home. Using my omron arm meter my best bp after1 1/2 hr was 177/120 pulse 96. Should I return to er or give the medicine more time?
[|AI|]  Hello Sir. I have read through your question and I can see that you're BP is not stabilizing. If I was your physician I would have put you on a calcium channel blocker a KE amlodipine and continued the Metropolis at 50 mg BD. As calcium channel blocker is very good at controlling BP at your age. Also, if your kidney function tests are normal it would be beneficial to start you on a thiamine diuretic like HY Chat Doctor.  You can discuss this with you are physician. Hope that answers your question. Please feel free to write If you have any further questions.