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There seems to be many 'Blood Pressure Classifications'. What would be the best and why so many types of classifications?

 

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Posted

Madiplot gave me water retention.

My legs and feet swelled up  significantly.

The doctor adjusted my meds and everything returned to normal.

Posted
12 hours ago, ravip said:

There seems to be many 'Blood Pressure Classifications'. What would be the best and why so many types of classifications?

 

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The ISH 2020 guidelines are the latest edition of the International Society of Hypertension Global Hypertension Practice Guidelines, released in 2020. As a result, they represent the most rigorous and evidence-based guidelines available. Based on this, I highly recommend considering the ISH 2020 guidelines when seeking hypertension practice guidelines.

  • Like 1
Posted
1 hour ago, jaiyenyen said:

Madiplot gave me water retention.

My legs and feet swelled up  significantly.

The doctor adjusted my meds and everything returned to normal.

Interesting. Were you taking 10mg or 20mg?  I've been on 10mg for 5 years without any side-effects.

Posted
1 hour ago, brewsterbudgen said:

Interesting. Were you taking 10mg or 20mg?  I've been on 10mg for 5 years without any side-effects.

Madiplot is a calcium channel blocker. Same class as amlodopine.

 

Swelling of feet and legs is a known side effects of this class of dtug.

 

Side effects do not occur in all patients. This particular effect occurs in about 1/4 of people taking these medications i.e. 3 out 9f 4 people do not experience it. 

 

  • Like 1
Posted
3 hours ago, mokwit said:

Anyone heard of Losartan causing extreme fatigue (can't do normal routines)?

Are you feeling this msmsinly in your legs?

 

Weskness/heaviness in ghr legs is a known (but not very common) side effect. 

 

Overall fatigue is not common. When did this start?

 

and when did you last have a complete check up?

 

Any other underlying diseases? Other medications?

 

 

Posted (edited)
52 minutes ago, Sheryl said:

Are you feeling this msmsinly in your legs?

 

Weskness/heaviness in ghr legs is a known (but not very common) side effect. 

 

Overall fatigue is not common. When did this start?

 

and when did you last have a complete check up?

 

Any other underlying diseases? Other medications?

 

 

Sheryl, what follows is quite involved and maybe off topic, so if you don't want to go there that is understood.

 

Noticed "stiffness" in my legs over a number of days following starting the drug that caused me to reduce the length of my usual morning walk.

 

Started a few days after starting Losartan

 

Had pre admission checks for surgery in Nov.  Currently having most blood things monitored.

 

Here's the difficult part - stage 4 colon cancer that has spread to the lungs but not the liver as of 1 year ago MRI scan and Alkaline Phosphatase is normal. 6 months of XELOX chemo ending Oct 26th - 2 weeks before Losartan started I seemed to be finally getting my energy and motivation back then after about a week after starting Losartan I just crashed and spent days in bed.If you just looked at the starting Losartan and the result it might seem to be Losartan, but I got more busy than normal and maybe triggered chemo related Chronic Fatigue Syndrome.

 

Oncologist asked me the name of the drug and when I said "Losartan", replied "it's the drug" with such seeming conviction that I did not ask for supporting factors. She didn't believe it was the chemo coz all blood counts e.g RBC were back to normal. The internet says different.

 

this was the pattern (figures are blood pressure):

2-Feb    133    80        132    72    losartan 1 Feb evening    
3-Feb    127    76        129    71    NORMAL 2 WEEKS PRIOR  
4-Feb    122    81        121    67    WEAKENING    
5-Feb    122    74        122    63    WEAKENING    
6-Feb    125    82        118    70    WEAKENING    
7-Feb    130    84        121    68    WEAKENING    
8-Feb    139    84        122    73    WEAKENING    
9-Feb    129    83        113    75    WEAKENING    
10-Feb    139    77        126    74    WEAK    
11-Feb    130    86        115    70    WEAK    
12-Feb    123    72        118    69    EXTREME FATIGUE    
13-Feb    120    70        113    73    EXTREME FATIGUE    
14-Feb    127    74        120    72    EXTREME FATIGUE    
15-Feb    123    68        113    67    EXTREME FATIGUE    
16-Feb    131    75        110    65    EXTREME FATIGUE    
17-Feb    136    81        129    71    EXTREME FATIGUE    
18-Feb    132    79        121    68    EXTREME FATIGUE    
19-Feb    134    84        121    67    NO Lotarsan pm    
20-Feb    133    81        120    70    Stop Lotarsan T-1    
21-Feb    124    77        118    67    EXTREME FATIGUE    
22-Feb    124    85        120    69    EXTREME FATIGUE    
23-Feb    123    76        119    66    Start recover (1/2 day)    
24-Feb    135    79        117    69    HALF DAY    
25-Feb    132    81        122    69    Full Day    
26-Feb    137    75        125    71    HALF DAY    
27-Feb    140    86        129    72    HALF DAY    
28-Feb    134    83                HALF DAY    
1-Mar    124    83        123    70    HALF DAY    
2-Mar    129    83        115    71    HALF DAY    
3-Mar    131    75        114    72    HALF DAY    
4-Mar    137    86        125    76    HALF DAY    
5-Mar    128    81                HALF DAY    
6-Mar    135    83        129    72    HALF DAY    
7-Mar    134    83        114    76    HALF DAY    
8-Mar    129    84        121    71    HALF DAY    
9-Mar    134    77        124    71    HALF DAY    
10-Mar    139    82        123    72    HALF DAY    
11-Mar    133    78        117    70    HALF DAY    
12-Mar    139    80                HALF DAY    
13-Mar    121    81        117    68    HALF DAY    
14-Mar    128    73        126    73    HALF DAY    
15-Mar    136    81        123    69    HALF DAY    
16-Mar    126    83        118    68    NEAR NORMAL    
17-Mar    128    76        126    71    NEAR NORMAL    
18-Mar                116    63    NEAR NORMAL    
19-Mar    133    76        121    71    NEAR NORMAL    
20-Mar    118    72        122    71    NEAR NORMAL    
21-Mar    136    81        118    72    NEAR NORMAL    
22-Mar    132    78        125    71    NEAR NORMAL    
23-Mar    120    77                NEAR NORMAL    
24-Mar    125    80        121    71    NEAR NORMAL    
25-Mar    128    71        119    65    NEAR NORMAL    
26-Mar    130    77        127    71    WEAK    
27-Mar    127    77        120    70    WEAK    
28-Mar    119    75        120    65    EXTREME FATIGUE    
29-Mar                126    72    HALF DAY    
30-Mar    117    78        122    70    EXTREME FATIGUE    
31-Mar    130    79        120    73    HALF DAY    
1-Apr    116    78        126    71    EXTREME FATIGUE    
 

While cancer may be the obvious cause - there seem no other symptoms yet that would indicate that stage.

 

From a medically qualified friend: fatigue due to cancer usually presents with other findings such as,focal pain, abnormal lab values, abnormal imaging findings, symptoms in the organ system (heart, lungs GI tract etc.) where the primary or mets may have occurred, worsening pain without pain meds, the fatigue does not lessen with time and not receiving a cycle of chemo,  specific signs such as jaundice, cough, skin lesions , weight loss, loss of appetite etc.etc

However, it may be hard to discern chemo vs cancer related fatigue, if there are only very early and/or subtle findings......often time will tell after early overlapping possibilities. In other words the cause usually declares its etiology in time.
I hope this helps considering that there is no absolute definitive interpretation of the cause fatigue early on inits course after numerous cycles of chemo.

 

Edited by mokwit
Posted

Repeatedly rejected from donating blood aged 30 and referred to my GP. BP readings were around 165/110. GP prescribed Furosemide, advising she would gradually reduce the dose to zero. My BP would return to normal and remain normal without medication. Absolutely correct! I was then able to recommence donating blood plus plasma and platelets and have also participated in many clinical trials. Current BP readings at age 66; 128/80.

 

What is mystifying is the tutting and shaking of the head by doctors when they read my history and I tell them this story. According to them, this method of treatment cannot work. Either the sphygmomanometers were faulty or the staff weren't reading them correctly?

Posted

@mokwit

 

Yoh did not realky answer my first question which is if the weakness/fatigue is mainly in the legs vs all over.

 

Losartan can cause stiff/weak legs but is a less likely explanation for extreme over all fatigue.

 

You also don't mention chemo dates. How long since last given?

 

And when was your last CBC? (Blood count). Extreme fatigue in chemo patients often accompanies  drop in RBC/WBC and this can come on quite suddenly. Unless you had a CBC in past 2 week I would suggest to repeat it and when you do, also check electrolytes.

 

Make sure to  stay well hydrated in this heat. Abd replace electrolytes if you have been sweating.

 

How hugh wsdad  BP before starting losartan? And what dose are you on? 

Posted (edited)
16 minutes ago, Sheryl said:

@mokwit

 

Yoh did not realky answer my first question which is if the weakness/fatigue is mainly in the legs vs all over.

 

Losartan can cause stiff/weak legs but is a less likely explanation for extreme over all fatigue.

 

You also don't mention chemo dates. How long since last given?

 

And when was your last CBC? (Blood count). Extreme fatigue in chemo patients often accompanies  drop in RBC/WBC and this can come on quite suddenly. Unless you had a CBC in past 2 week I would suggest to repeat it and when you do, also check electrolytes.

 

Make sure to  stay well hydrated in this heat. Abd replace electrolytes if you have been sweating.

 

How hugh wsdad  BP before starting losartan? And what dose are you on? 

First noticed stiffness and lack of stamina in the legs - worsening of what started after chemo session 5.  Generally not so much weak bodily in terms of strength but just feel extremely fatigued and ill to the point of staying in bed.

 

This from wiki pretty much describes it:

  1. Greatly lowered ability to do activities that were usual before the illness. This drop in activity level occurs along with fatigue and must last six months or longer.
  2. Worsening of symptoms after physical or mental activity that would not have caused a problem before the illness. The amount of activity that might aggravate the illness is difficult for a person to predict, and the decline often presents 12 to 48 hours after the activity.[28] The 'relapse', or 'crash', may last days, weeks or longer. This is known as post-exertional malaise (PEM).
  3. Sleep problems; people may still feel weary after full nights of sleep, or may struggle to stay awake, fall asleep or stay asleep.

Additionally, one of the following symptoms must be present:[15]

  • Problems with thinking and memory (cognitive dysfunction, sometimes described as "brain fog")

 

https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome

 

Also:

Post-exertional malaise

PEM is triggered by "minimal"[3] physical or mental activities that were previously tolerated, and that healthy people tolerate, like attending a social event, grocery shopping, or even taking a shower.[2] Emotional distress, injury, sleep deprivation, infections, and spending too long standing or sitting up are other as potential triggers.[4] The resulting symptoms are disproportionate to the triggering activity and are often debilitating, potentially rendering someone housebound or bedbound until they recover.[5][4][6][2]

 

Had this during chemo after walking back from Chula. Nice walk then next 2 days in bed.

 

https://en.wikipedia.org/wiki/Post-exertional_malaise

 

 

Last chemo was Oct 26th - 8 sessions over 6 months Xelox.

 

RBC/WBC have always been normal/above threshold throughout. Last was in March when I was already had been feeling the extreme fatigue. Oncologist pointed to RBC/WBC being normal as indication it was not chemo caused.

 

Well hydrated and not sweating as in aircon nearly 24/7

 

Dose was 50mg starting 1 Feb and stopped 19 Feb.. Blood pressure values were similar:

 

3-Jan 150 82   134 75    
4-Jan 137 79   120 75    
5-Jan 134 78   109 64    
6-Jan 134 79   127 91    
7-Jan 140 78   129 73    
8-Jan 137 79   123 70    
9-Jan 132 78   110 70    
10-Jan 125 82   128 77    
11-Jan 125 73   121 69    
12-Jan 138 74   128 73    
13-Jan 139 81   137 77    
14-Jan 131 76   122 70    
15-Jan 122 80   126 70    
16-Jan 120 76   128 72    
17-Jan 138 83   121 76    
18-Jan 136 81   110 67    
19-Jan 143 78   128 69    
20-Jan 133 82   136 77    
21-Jan 119 85   137 78    
22-Jan 145 81   116 76    
23-Jan 131 84   125 72    
24-Jan 137 82   127 70    
               
               
25-Jan 146 80   126 71    
26-Jan 137 77       Motivation Go out, eat healthy
27-Jan           Taste for food
  amS amD   pmS pmD    
2-Feb 133 80   132 72 losartan 1 Feb evening
3-Feb 127 76   129 71 NORMAL 2 WEEKS
4-Feb 122 81   121 67 WEAKENING
5-Feb 122 74   122 63 WEAKENING
6-Feb 125 82   118 70 WEAKENING
7-Feb 130 84   121 68 WEAKENING
8-Feb 139 84   122 73 WEAKENING
9-Feb 129 83   113 75 WEAKENING
10-Feb 139 77   126 74 WEAK  
11-Feb 130 86   115 70 WEAK  
12-Feb 123 72   118 69 EXTREME FATIGUE
13-Feb 120 70   113 73 EXTREME FATIGUE
14-Feb 127 74   120 72 EXTREME FATIGUE
15-Feb 123 68   113 67 EXTREME FATIGUE
16-Feb 131 75   110 65 EXTREME FATIGUE
17-Feb 136 81   129 71 EXTREME FATIGUE
18-Feb 132 79   121 68 EXTREME FATIGUE
19-Feb 134 84   121 67 NO Lotarsan pm
20-Feb 133 81   120 70 Stop Lotarsan T-1
21-Feb 124 77   118 67 EXTREME FATIGUE
Edited by mokwit
Posted
11 minutes ago, mokwit said:

First noticed stiffness and lack of stamina in the legs. Generally not so much weak bodily in terms of strength but just feel extremely fatigued and ill to the point of staying in bed.

 

Last chemo was Oct 26th - 8 sessions over 6 months Xelox.

 

RBC/WBC have always been normal/above threshold throughout. Last was in March when I was already had been feeling the extreme fatigue. Oncologist pointed to RBC/WBC being normal as indication it was not chemo caused.

 

Well hydrated and not sweating as in aircon nearly 24/7

 

Dose was 50mg starting 1 Feb and stopped 19 Feb.. 

        118 67 EXTREME FATIGUE

 So you stopped losartsn 19 Feb? But still feeling tired?

Posted (edited)
7 minutes ago, Sheryl said:

 So you stopped losartsn 19 Feb? But still feeling tired?

Yes, but not the extreme stay in bed all day that I had while I was taking it. Seemed to recover from needing  to stay in bed a few days after I stopped it. Have had some day almost like that.

 

2-Feb    133    80        132    72    losartan 1 Feb evening    
3-Feb    127    76        129    71    NORMAL 2 WEEKS    
4-Feb    122    81        121    67    WEAKENING    
5-Feb    122    74        122    63    WEAKENING    
6-Feb    125    82        118    70    WEAKENING    
7-Feb    130    84        121    68    WEAKENING    
8-Feb    139    84        122    73    WEAKENING    
9-Feb    129    83        113    75    WEAKENING    
10-Feb    139    77        126    74    WEAK    
11-Feb    130    86        115    70    WEAK    
12-Feb    123    72        118    69    EXTREME FATIGUE    
13-Feb    120    70        113    73    EXTREME FATIGUE    
14-Feb    127    74        120    72    EXTREME FATIGUE    
15-Feb    123    68        113    67    EXTREME FATIGUE    
16-Feb    131    75        110    65    EXTREME FATIGUE    
17-Feb    136    81        129    71    EXTREME FATIGUE    
18-Feb    132    79        121    68    EXTREME FATIGUE    
19-Feb    134    84        121    67    NO Lotarsan pm    
20-Feb    133    81        120    70    Stop Lotarsan T-1    
21-Feb    124    77        118    67    EXTREME FATIGUE    
22-Feb    124    85        120    69    EXTREME FATIGUE    
23-Feb    123    76        119    66    Start recover (1/2 day)    
24-Feb    135    79        117    69    HALF DAY    
25-Feb    132    81        122    69    Full Day    
26-Feb    137    75        125    71    HALF DAY    
27-Feb    140    86        129    72    HALF DAY    
28-Feb    134    83                HALF DAY    
1-Mar    124    83        123    70    HALF DAY    
2-Mar    129    83        115    71    HALF DAY    
3-Mar    131    75        114    72    HALF DAY    
4-Mar    137    86        125    76    HALF DAY    
5-Mar    128    81                HALF DAY    
6-Mar    135    83        129    72    HALF DAY    
7-Mar    134    83        114    76    HALF DAY    
8-Mar    129    84        121    71    HALF DAY    
9-Mar    134    77        124    71    HALF DAY    
10-Mar    139    82        123    72    HALF DAY    
11-Mar    133    78        117    70    HALF DAY    
12-Mar    139    80                HALF DAY    
13-Mar    121    81        117    68    HALF DAY    
14-Mar    128    73        126    73    HALF DAY    
15-Mar    136    81        123    69    HALF DAY    
16-Mar    126    83        118    68    NEAR NORMAL    
17-Mar    128    76        126    71    NEAR NORMAL    
18-Mar                116    63    NEAR NORMAL    
19-Mar    133    76        121    71    NEAR NORMAL    
20-Mar    118    72        122    71    NEAR NORMAL    
21-Mar    136    81        118    72    NEAR NORMAL    
22-Mar    132    78        125    71    NEAR NORMAL    
23-Mar    120    77                NEAR NORMAL    
24-Mar    125    80        121    71    NEAR NORMAL    
25-Mar    128    71        119    65    NEAR NORMAL    
26-Mar    130    77        127    71    WEAK    
27-Mar    127    77        120    70    WEAK    
28-Mar    119    75        120    65    EXTREME FATIGUE    
29-Mar                126    72    HALF DAY    
30-Mar    117    78        122    70    EXTREME FATIGUE    
31-Mar    130    79        120    73    HALF DAY    
1-Apr    116    78        126    71    EXTREME FATIGUE    
 

 

Note this:

10-Feb    139    77        126    74    WEAK    
11-Feb    130    86        115    70    WEAK 

AND

26-Mar    130    77        127    71    WEAK    
27-Mar    127    77        120    70    WEAK  

Got 2 day warning (with hindsight) as started feeling unwell fatigued when doing normal things.

 

Note I have added some things to post.

Edited by mokwit
Posted

It appears that the losartan was at most just a part of the problem since wermeks after stopping you are still weak more often than not.

 

Also seems your BP off it is not too bad. 

Posted (edited)
10 minutes ago, Sheryl said:

It appears that the losartan was at most just a part of the problem since wermeks after stopping you are still weak more often than not.

 

Also seems your BP off it is not too bad. 

Yes I crashed again after stopping Losartan and recovering. There was a 3 week period when I was motivated and active again - the third week coinciding with Losartan. Maybe I just overdid it for how well recovered I was['nt] from chemo and triggered a crash independent of Losartan.

 

 

I tend to think this is Chemo related. Same thing but 2 or 3 times worse than when on chemo - but on chemo I exerted less and rested more.

 

Edited by mokwit
Posted

180/112 last year but been like that for a decade. I returned to Australia for work and found a good GP who told me even a driving license was out of the question. 

Telmisartan+Amlodipine put me in the right direction so now around 125/83 so all good. Rate@40-5 mg per day.

Stay of the grog was her advice, mostly..

I got a job as a hard rock underground truck driver at age 63 so yes most things are possible lf you try.

 

 

 

 

 

  • Love It 1
Posted
11 minutes ago, sherwood said:

180/112 last year but been like that for a decade. I returned to Australia for work and found a good GP who told me even a driving license was out of the question. 

Telmisartan+Amlodipine put me in the right direction so now around 125/83 so all good. Rate@40-5 mg per day.

Stay of the grog was her advice, mostly..

I got a job as a hard rock underground truck driver at age 63 so yes most things are possible lf you try.

That's wonderful. Very pleased for you! Somethings obviously change (and for the better). At one time your history would have precluded such (or even most) employment. Employers must now recognise that conditions which can be kept well under control should be no bar to employment?

  • Thumbs Up 1
Posted

Yer I was lucky as medicals are mandatory for most jobs these days. Worked for 10 months, 12 hrs by 14 days and hope I never do it again.

I think I could do it one more time if the site was Ok. 

Good remuneration for sure.

 

  • Love It 1
Posted (edited)

At age 49, and 105kg at 185cm, I take 100mg Losartan (120-125/75-80) - unmedicated it's about 135-145/85-90.

 

Also take a beta blocker (Carvidilol 12.5mg) to slow the RHR down to 70-75 bpm, from 90ish unmedicated.

 

I've seen so many expats in the Philippines and LOS needlessly drop dead way too early because they were too stupid or too lazy to monitor their most basic vitals. It's really almost Darwinian. A dumb as riding motorbikes without helmet/drunk etc.

Edited by Sandboxer
  • Thanks 1
Posted
On 4/4/2023 at 7:45 PM, Woof999 said:

Thai doctor at Bangkok Hospital Pattaya took me off my UK atenolol prescription and changed it to cozaar / losartan. Said it was better for me, easier to buy here and cheaper.

I was prescribed atenolol in the UK back in 1980 and then about 20 years later the doctor took me off that and put me on an Ace inhibitor. I was under the impression that was UK policy at the time unless there were side effects.

Posted
On 4/4/2023 at 7:35 PM, Stocky said:

I was diagnosed with hypertension aged 35 .

I was also diagnosed early thirties, i think I had it when I was discharged from the RAF when I was 30, bit of farting about getting my papers signed.  After first reading had to wait for half an hour, then after the second scratched his head and picked up the pen.

As you say I am sure it runs in families.

Posted
On 4/4/2023 at 5:10 PM, steveb5 said:

What is the blood pressure range that medication is necessary. My blood pressure after a second reading averages about 135 but first reading sometimes around 145 average.

You haven't said how old you are. Some will say age has nothing to do with it, but it does.

If you are 90,  you don't really have anything to worry about, chances are you will die before it deteriorates much more.

If however you are 50 you ought to be taking some precautionary measures.

Posted
26 minutes ago, The Fugitive said:

musn't bother our doctor's unless we have some serious complaint that we've put up with for a long time and it's been getting worse.

Wasn't that just it in the UK. Patients were regarded as a nuisance.

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Posted
1 hour ago, sandyf said:

I was prescribed atenolol in the UK back in 1980 and then about 20 years later the doctor took me off that and put me on an Ace inhibitor. I was under the impression that was UK policy at the time unless there were side effects.

Beta blockers are no longer recommended for first lien treatment of hypertension (though they are still very useful for other things including some heart conditions).

 

For first line treatment of hypertension nowasdays: ACE inhibitor, ARB, or calcium channel blocker.

 

If these alone do not do the trick, or if there is heart failure present,  a diuretic may be added.

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Posted

 

Put on Enalapril 20 MG 2x day back in the 1990s in the UK

 been here just over 19 years many Dr here have tried to change  to ? better  ? Newer Med"s that did not work or bad reactions..

 

last 7 years been on  1x evenings Prenolol 25mg + 1x mornings Losartan 50 mg + 1 x evenings 2 mg Dozozin    [one Dr mixed more pills in my Prescriptions for BP with bad results]

For years take at home my BP at least 1 x day, normally 130 - 140 over 68 -78

 

Age: 72  - 1.88 tall -  103 kg

 

No idea why will suddenly go up 220/130 or suddenly drop 54/32 + passing out... 

 

Madiplot, lisinopril and amlodopine. I cannot take both give bad swelling of legs/ankles/feet

 

The annoying things here.... the moment you get to Hospital they must do BP reading sometimes this can be high = your on a bed in a moment and given 2 or 3 different pills.. Never found out what they are, + or an injection of ? no idea.

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Posted (edited)
2 hours ago, sandyf said:

So you think that 140/80 would mean the same to a 35 year old as an 85 year old.

What did the statement say? Both cases would need meds, or a change of lifestyle, to bring the numbers into normal range.

 

The 85 year old doesn't get a free pass. But he's probably let himself go so many years already that I'd question how much lifestyle change alone--to the extent achievable--could help. Some, perhaps, depending on his condition. He'd probably just add meds to his current stack.

 

A study of interest:

 

The researchers concluded that, for adults aged 80 years or older, intensively controlling systolic blood pressure to less than 120 mmHg lowers the risk of heart attacks, stroke, death, and mild cognitive impairment, but increases the risk of declines in kidney function. [most got the kidney issue under control]

 

     --Blood Pressure Control for People Aged 80 and Older: What’s the Right Target?

Edited by BigStar

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