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

### input:
i have high blood pressure and are on the lowest dose of ramipril, 1.25 mg,howver, my legs  are very shaky tonight. I have had this a few times recently. i took my blood pressure tonight and it is sky high  167/93.  i think i have to call  my cardiologist tomorrow. I take ramipril at night. should I dou7ble the dose tonight to 2.5 mg?  i have gradually come down slowly from 10 mg  2 years ago, but maybe 1.25 is too low. i have been on it for only 3.5 months.

### output:

Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. Ii will give you my opinion. When we treat hypertension our goal is to achieve mean values below 140/90 mmHg. A hypertensive patient might have excessive values under physical or emotional stress and this is normal but when we talk about daily mean values they should be under 140/90. Only with these values we can say that we have a good and controlled blood pressure. So, if you say that in a random measurement you find high values like 167/93 it might be reasonable to rise your medicament dosage. In fact the April dose that you take is a very small one. So my opinion as a cardiologist is that you can rise the dosage to 2.5 and even 5 mg because it can't cause any harm. It will lower your blood pressure values to 120/80 and this is our target for you. Of course, it is mandatory to know some blood analyses to do so like your creatinine levels, so I advise you to consult it with your cardiologist. Hope I was helpful. Wish you good health. Best regards.