### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, may I answer your health queries right now ?  Please type your query here...I have been on 12.5mg 1x daily of hydrochlorithiazide for about 1 1/2 yrs. for moderate high blood pressure 145/90.At first my blood pressure improved to 120/80 or lower.  About 4 mos ago at my yrly checkup my blood pressure was 130/85. I thought that was high but my Dr. did not say anything and did not adjust my medicine. Recently I am experiencing headaches, extreme fatigue and some intermmittent bouts of dizziness.  These were the same sypmtpoms I had pre diagnosis and tx. I am now wondering if my medicine should be increased to at least 25 mg daily or higher or another medicine.  I also sometimes can feel my heart beat or pulse in my ears and neck when lying down to sleep or even when I awake in the morning.

### output:

Hi.  Sounds like you may need to adjust your BP medications.  First thing I would do is check your BP at home with a machine.  If you don't have one I suggest getting one.  Common is a good brand. Best to check first thing in the AM when you are relaxed or when you feel dizzy or fatigued. Several options.  One is diet.  Less salt and processed foods.  Try organic foods if possible.  Moderate exercise may also be beneficial. If this doesn't help, then the options are to increase HCT to 25 mg daily or a combination pill such as HCT/ACE INHIBITOR. There are quite a few of these meds, and they are usually the first choice for high BP as per JNC (Joint National Commission) 8 guidelines.  Hope this helps.