<s>[INST] My mother is on blood pressure pills. The doctor originally prescribed 4mg for her blood pressure, but when reading the literature inside it recommends 2mg for the elderly, so that is what we went with for a week then to bump up to 2 if needed. Upping it has not been needed. Her systolic is running in a good range, however, her diastolic is running in the 40-50 range which I am concerned about. Pulse sometimes in the high 80 s. She has some thickening of the heart wall. Is this the contributing problem to a low diastolic? What is the issue? Should she see an internist/cardiologist? [/INST] Hello! Thank you for asking on HCM! Regarding your concern, I would explain that whichever is the anti-hypertensive drug name, or the drug combination used for that purpose, doses are decided  by treatment response, specific age- and co-morbidity implications, etc. You should consult your treatment effects with the prescribing doctor, to decide the most appropriate maintenance therapy. Regarding the increased pulse pressure difference, some additional disorders must be excluded, such as aortic insufficiency, thyroid dysfunction, hypovolemia, etc.I recommend to discuss wit h an internist or cardiologist about these issues.Hope to have been helpful. Greetings! Dr. Iliri. </s>