Dear sir,

My grandmother is 72 years on antihypertensives such as

Tenormin 25mg od
Hydralazine 50mg bid
Hydrochlorothiazide 12.5mg od
Diovan 160mg bid
she is also diabetic on Insulin mixtard 35units Sc before breakfast.
Hypothyroidism on L- thyroxine 125mcg od, Hyperlipidemia , on lipostat 20 mg hs.
Even with these her Blood pressure is usually around 210/100 Morning, by evening 180/ 70mmof hg. min Sys BP 160 for her.
She is also having Permanent pacemaker for 2nd degree type 2 heartblock, HR 60-66bpm.I would like to have an expert opinion in this matter.