Managing Medications for Seniors: Monopril Hct & Actos - A Concerned Family Inquiry

Question
My mother is 86 and recently (3 months or so ago) was put on both Monopril Hct (10/12.5)for high blood pressure (systolic in the 150-160s) and Actos for blood sugar problems. She had not been on any medication prior to that. Her systolic pressure is now in the 130s but her diastolic is low - in the 50s.  She was taking only a half pill of the Monopril but the doctor increased it to a full pill  a few weeks ago (once daily) because the systolic pressure was not low enough. She complained to me that she feels tired and she actually fainted momentarily last night while standing at the sink. She was able to get up and feels better today, but I am concerned. Her doctor is out of town this week. I looked on the internet because the diastolic was so low, and I think this might be a cause of her problem? Does monopril affect both systolic and diastolic pressure? Is there a way to reduce systolic pressure and increase diastolic? Or do you just have to accept a higher systolic if the diastolic is too low on her current dose? I don't know what her diastolic was before the meds but I have to imagine it was higher than 50-60. Also: how does the Actos possibly fit into this? Any information you can provide is appreciated!

Answer
Actos doesn't have anything to do with it.  She may have some hardening of the arteries which falsely elevates the systolic blood pressure....  I suspect that is the case, so her real systolic blood pressure is lower.  It is called Osler's Maneuver to determine this.  She is probably on too much BP meds and getting low blood pressure reactions which can be bad if she falls and breaks a hip.  Get in touch with him  or his partner for permission to lower the dose of meds right away.