High Blood Pressure

Have you ever seen a patient with blood pressure in this range? This is what happens.

Last two weeks, he (my client) came to check his BP and his systolic BP is in 190 range. I refer him to district hospital for follow up. So, he went to the district hospital and he was asked to check his BP every 2 days for 2 weeks, and then fill in a paper before the appointment.
No medications was taken that time.

Yesterday, around 4pm, he came and i was surprised that his BP is 210/117 mmHg. I double check with his right hand after some resting, and the result shows the same (215/122mmHg). What would you do if you're me? Therefore, I quickly refer him to the hospital and he promptly left.

At the same night, 8pm, he came back to me and told me what happened. He was attended by A& E Dr and was detained for 2 hours. During the 2 hours there, first he was given an injection (maybe labetalol inj??) and was released after BP taken 2 hours later. I believe his BP should have came down before his release.

So now, he came to my pharmacy with a prescription for Atenolol 50mg. I checked his BP, it is again 201/116mmHg and 180/114mmHg. What should i do? I already refered him to the hospital twice and it seems there is not much interventions done. My client seems to be lethargic after so much things he went through.

First visit to hospital:
Came back with a paper to be filled with two weeks BP reading for hypertension confirmation.

Second visit:
Came back with prescription for Atenolol 50mmHg and another paper to be filled with BP readings.

My advice to him:
To take atenolol 100mg on the same night and take rest. Check your BP again tomorrow and see your doctor again if it is still high.

Pharmacist quote:
Severe hypertension is defined as a diastolic BP of 115mmHg or greater. It may cause rapid and progressive end-organ damage, particularly in cardiovascular, renal and central nervous systems.

Comments?? Any better ideas?