<s>[INST] i a 43 year old woman, slim and active, I dont smoke, i avoid salt and i exercies at the gym 3 times a week plus i exercise daily walking my dog. I am currently taking 5mg Ramipril however on monitoring my blood pressure at home it is still high at 149/78. What could possibly be causing this and what else can I do to bring it down? [/INST] Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, we should first rule out diabetes and dyslipidemia because both these can cause poor control of blood pressure. So get done sugar level and lipid profile. If both are normal then you should consult your doctor to increase the dose of ramipril. You are taking minimal dose of ramipril. You can increase the dose to 5mg twice daily. Ideal dose of ramipril is twice daily only. So consult your doctor, get tested for diabetes and dyslipidemia and discuss about increasing ramipril to control your blood pressure. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>