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> "Ok, so I have a whole string of mostly women over 80 who no matter > what I do, I cannot get their systolic below 180/190 without serious > side-effects, both perceived by the patient ie "I feel awful doctor" > and physiological ie urea and creat rising through the roof. I have a patient like that. I borrowed an ambulatory BP machine and put it on this patient. The daytime BP's were 190/90. After she was asleep the BP dropped to 90/60 and started to rise shortly before she woke up. Diuretics did not change the readings and I am reluctant to start her on medication as she feels fine. She is off to a consultant for his opinion. Ray Ray Simkus [log in to unmask] 1-604-530-1181 voice 1-604-530-5609 fax %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%