दिल की विफलता और उच्च रक्तचाप को मैनेज करने के लिए क्या सिफारिशें हैं? - #48819

Thank you, Ali, for sharing your detailed information. I’ve reviewed your labs, imaging, and clinical history carefully

While seeing your parameters-

- Your blood pressure is 138/86 mmHg, which is slightly above normal (prehypertension/mild hypertension). - You have heart failure (duration >6 months). The fact that your weight has dropped from 74 kg to 60 kg is significant — that’s ~19% weight loss, which may reflect muscle loss, nutritional deficiency, or worsening heart failure. - Pulse is normal at 68 bpm, which is reassuring. - Serum creatinine: 84 μmol/L – normal - Urea nitrogen: 3.8 mmol/L – normal - Urine albumin/creatinine ratio: 73 mg/g – elevated (microalbuminuria), which indicates kidney stress, possibly due to hypertension or heart failure.

- Leukocytes: 3.8 × 10³/μL – slightly low, may indicate mild immunosuppression or nutritional deficiency - Platelets: 122 × 10³/μL – mildly low - Other indices (Hb, Hct, RBCs) are normal.

- Chronic calculous cholecystitis (gallstones) with dilated CBD – this requires specialist evaluation, especially before considering surgery.

- Cholesterol: 6.24 mmol/L – slightly elevated - HDL: 2.38 mmol/L, LDL: 2.94 mmol/L – reasonable - HbA1c: 5% – normal

- Electrolytes, liver enzymes, and pancreas are essentially normal. - Kidney imaging shows minor stones, no obstruction.

You are currently on: - Gokshuradi Guggulu – supports kidneys, urinary system - Punarnavadi Mandur – supports heart, anemia, edema - Ashwagandha Churna – supports strength, immunity, stress, and heart function - Shatavari Churna – supports general vitality and digestion

✨With low platelets and WBCs, Guggulu and Mandur can sometimes affect liver and hematology, so monitoring is important.

Advice from my side- Continue with heart medicine as earlier prescribed.

- Gokshuradi Guggulu: 250–500 mg twice daily after meals with warm water or milk - Punarnavadi Mandur: 1 tablet (250 mg) twice daily after meals with lukewarm water - Ashwagandha Churna: 3–5 g with warm milk at night - Shatavari Churna: 3–5 g with warm milk or water, preferably at night

Notes: Avoid high salt, processed foods, and excess oil/fat — critical for heart failure. Monitor weight, edema, urine output, and fatigue daily. If you notice sudden swelling, breathlessness, or rapid weight gain, seek emergency care

Monitoring and Investigations are must -

- Repeat CBC, kidney function, liver enzymes every 3 months - Blood pressure monitoring daily - Gallbladder and CBD follow-up with gastroenterologist - Echocardiogram (if not done recently) to assess heart function

Lifestyle Advice - Light walking or yoga if tolerated - Adequate hydration, but avoid excessive fluids if heart failure causes swelling - Gentle strength training to prevent muscle loss

Tq