Where things stand
Your seven-day average is the number that matters — single readings swing too much to act on. Aim for at least 14 days of twice-daily readings before your appointment.
Today's checklist
Small and repeatable beats comprehensive and abandoned.
Trend
Shaded band is the 130/80 target zone.
The plan, in short
Four moves, in order of leverage.
Aldosterone/renin ratio and a sleep study are the two highest-yield tests. Neither has been done. Both are open questions at your next appointment.
Two weeks of twice-daily home readings turns "I'd like to reduce my medication" into a data-backed request.
Weight, sodium, exercise and sleep are worth more combined than any single drug you're on.
One agent at a time, 4–6 weeks apart, moxonidine last and slowest.
Blood pressure log
Seated, back supported, feet flat, five minutes rest, cuff on bare upper arm at heart height. Two readings a minute apart — log the second. Same arm each time. Morning before medication, evening before dinner.
Add a reading
Trend
Systolic and diastolic over time, against the 130/80 target band.
Pulse
Verapamil slows heart rate. A downward trend here is directly relevant to your fatigue and dizziness — and to which drug gets reduced first.
All readings
—
| Date | Time | Sys | Dia | Pulse | Position | Band | Note |
|---|
Medications & supplements
Five antihypertensives across five classes. Tick each day to build an adherence record — gaps in adherence are the first thing a doctor will want to rule out before attributing a BP change to anything else.
Daily diary
Tick what you actually took. Honest beats tidy.
As-needed medications
Anything you take occasionally rather than daily — painkillers, Ventolin, antihistamines. Worth logging even when use is rare, because a cluster during a bad week is exactly the pattern that would otherwise get missed.
| Date | What | Dose | Reason | Class |
|---|
Your regimen
What each one does, and what it means for deprescribing.
| Drug | Dose | Class | Notes for review |
|---|---|---|---|
| Hydrochlorothiazide Dithiazide | 25mg STOPPED | Thiazide diuretic | Ceased 3 Aug 2026 First deprescribing step, chosen by GP as low-impact and once-daily. BP has held: 44 of 44 readings since remain under 130/80, averaging 116/69 versus 121/72 in the fortnight before. Stopping should also help the borderline urate of 0.48. |
| Verapamil Cordilox SR | 180mg morning | Non-dihydropyridine calcium channel blocker | Slows heart rate and cardiac conduction. Mean pulse since August is 62 with readings as low as 48 — query whether this is contributing to fatigue. Also used as a migraine and cluster headache preventive, so it may be doing double duty given your chronic headaches. If it is ever reduced, headaches could worsen — factor this into any taper decision. Avoid grapefruit. Curcumin may raise its levels. |
| Perindopril | 10mg night | ACE inhibitor | Confirmed at 10mg (the GP letter of 3 Aug recorded 8mg in error — worth correcting on the practice record). Kidney-protective; creatinine improved from 115 to 105 and eGFR from 69 to 77. Potassium normal at 4.0. |
| Moxonidine Physiotens | 400mcg night | Centrally-acting imidazoline agonist | Taper last Abrupt withdrawal risks severe rebound hypertension. Sedating. |
| Hydralazine Alphapress | 50mg three times daily | Direct vasodilator | Likely next candidate Heaviest dosing burden, weakest outcome data. Note it causes reflex tachycardia, so removing it could lower pulse further rather than raise it — worth raising given the current bradycardia. |
| Salbutamol | PRN | Beta-2 agonist | For asthma, used less than weekly. Can transiently raise heart rate. Relevant mainly because asthma rules out beta blockers as an alternative agent. |
| Allergy / intolerance: Minipress (prazosin) — lightheadedness, moderate. Alpha blockers should be approached cautiously. | |||
Supplements — points to raise
All four started recently and together, which makes attribution hard and overlaps with your fatigue and dizziness.
| Supplement | Dose | Why it matters here |
|---|---|---|
| Ashwagandha | nightly | Ask before bloods Can raise thyroid hormone levels, which could distort thyroid testing — one of the secondary-cause screens you want done. Reports of liver injury exist. Sedating, stacking with moxonidine. |
| Curcumin / turmeric | daily | Inhibits the enzyme pathway that clears verapamil, potentially raising verapamil levels. Mild antiplatelet effect. |
| Melatonin | 10mg | Well above the usual effective range (0.5–3mg). Higher doses often mean more morning grogginess, not better sleep. Modestly lowers overnight BP. |
| Amla | 1g | Mild antiplatelet activity. Generally well tolerated. |
| Vitamin B12 | 5000mcg | Harmless at this dose but only useful if you're actually deficient — worth adding B12 to the blood panel to find out. |
Symptoms & notes
Side effects are often the strongest argument for changing a regimen — but only if they're documented with dates. Log even mild days; the pattern is what's useful.
Add an entry
Weight
Roughly 1 mmHg systolic per kilogram lost. At 86kg and 167cm, an 8–10kg loss is a realistic and meaningful target.
Entries
| Date | Symptoms | Sleep | Energy | Weight | Note |
|---|
Weight tracker
Roughly 1 mmHg systolic per kilogram lost. At 167cm, moving from 86kg toward 76kg would take your BMI from about 31 to about 27 — and it is one of the few levers that also directly reduces sleep apnoea severity.
Log a weigh-in
Same time of day, same conditions — first thing in the morning after the toilet, before eating, is the most consistent. Weight swings 1–2kg day to day on fluid alone, so the trend line matters and any single reading does not.
Trend
Seven-day rolling average smooths out daily fluid swings and shows what is actually happening.
Weight and blood pressure together
Monthly averages of both, on their own axes. This is the view that shows whether they move together over time.
Correlation
Each point is a blood pressure reading paired with the nearest weigh-in within three days.
Entries
| Date | Weight | Change | BMI | Waist | Note |
|---|
Bloods & secondary-cause workup
This is the highest-value page in the app. Resistant hypertension at 40 in a never-smoker who doesn't drink, with a family pattern controlled on one or two drugs, is exactly the profile where an identifiable and often treatable cause is found.
Workup checklist
Tick as each is requested or completed. Bring this list to the appointment.
Record a result
| Date | Test | Value | Unit | Range |
|---|
Why each test is on the list
Primary aldosteronism is found in roughly one in five resistant hypertension cases and is routinely missed. If positive, treatment can dramatically reduce medication need — and there are familial forms, which is relevant given your family history.
You snore and wake unrested, with a BMI around 31. Obstructive sleep apnoea is a common driver of resistant hypertension and treating it can lower BP meaningfully.
Renal artery stenosis is a correctable cause. Doppler ultrasound or CT angiography.
eGFR, creatinine, and urine albumin:creatinine. Chronic kidney disease both causes and results from hypertension.
Thyroid dysfunction and hyperparathyroidism both raise BP and are simple blood tests.
Screens for phaeochromocytoma. Rare, but worth excluding if you get episodic palpitations, sweating or headache.
Distinguishes true resistance from white-coat effect and shows whether your BP dips overnight — non-dipping is itself a clue toward sleep apnoea.
Twelve-week plan
Built around an Achilles repair at eight months post-op, starting from no regular training. Regular aerobic exercise is worth roughly 5–8 mmHg systolic. The pool is doing real work here — it's the one modality that loads your cardiovascular system without loading the tendon.
Blood pressure: avoid breath-holding and straining under load. Heavy maximal lifting spikes BP sharply. Exhale on effort, keep resistance work in the 10–15 repetition range where you finish with two or three reps left in reserve, and skip anything that has you red-faced and holding your breath.
Phases
Log a session
| Date | Type | Min | Effort | Note |
|---|
Breathing practice
Slow paced breathing at around six breaths per minute has modest but real evidence in hypertension — roughly 3–5 mmHg with consistent daily practice. It costs ten minutes.
Sit upright. Inhale through the nose for a count of four, exhale gently for a count of six. No forcing, no breath-holding. Ten minutes, once daily — evening works well and may help sleep. This is one of the few things on the list with no interaction risk whatsoever.
Taper roadmap
This is a discussion document, not a schedule to execute. Every step below happens only if your doctor agrees to it, prescribes it, and monitors it.
Sequence, and the reasoning
Rules that apply at every step
Never reduce two agents in the same window. If BP rises, you need to know which change caused it.
Long enough for BP to find its new level and for any rebound to show itself.
Weekly averages, not individual readings, drive the decision.
Agree with your doctor in advance what triggers reversing course — for example a home average sustained above 140/90 for a week, or any single reading above 180/110.
Severe headache, chest pain, breathlessness, visual change, weakness or difficulty speaking during a taper means urgent medical attention, not a note in the app.
Realistic expectations
Some people with genuinely resistant hypertension need multiple agents indefinitely, and no amount of lifestyle work changes that. If a secondary cause is found and treated, the picture can change dramatically. If not, going from five agents to three with a cleaner side-effect profile and better-controlled numbers is a real win — not a failed attempt at getting to zero. Hold the goal loosely and the process tightly.
Doctor summary
Questions to ask
Import & backup
Everything stays in your browser. Nothing is uploaded anywhere.
Import from Samsung Health
In Samsung Health: Settings → Download personal data. You'll get a zip — unzip it and drop the individual CSV files here. Blood pressure, weight and exercise files are all supported.
Drop a CSV here, or
Install on your phone
This works as an installable app on Android — it gets a home screen icon, opens full screen without browser chrome, and works offline.
Review pack
Generates a single compact file summarising everything since your last review — averages, adherence, trends, changes, and the raw readings. Built to be handed to an AI assistant or read by a person, and self-contained so no re-briefing is needed.
Sync between devices
Enter the same passphrase on every device. Your data is encrypted in the browser before it is uploaded — the server only ever stores an unreadable blob, and the passphrase is never sent anywhere.
Advanced — separate Worker URL only if not hosted on Cloudflare
Leave this empty when the app is hosted on Cloudflare Pages — it finds the sync endpoint automatically on the same address. Only fill it in if you are running the app from a local file and pointing at a separately deployed Worker.
Backup
Download everything as a single file, or load one back in. When you load a backup you will be asked whether to merge it into what is already here (safe — nothing is deleted) or replace everything. Merge is the right choice for moving phone data onto desktop or vice versa.
What is stored
A live count of everything in the app on this device.
Clear data
Permanent. Download a backup first.