<s>[INST] My Dad is 90 years old. He is currently taking shots to correct his prostrate problems through his neurologist. He has a horse shoe kidney. I stopped his glipizide weeks ago because it would lower his sugar level to the 40 s in the morning and now he has 98 readings in the morning. However, his blood pressure was always floating high to normal. Recently, too high 200 over 98. He is taking two medicines for HBP. What could be causing pressure increases? [/INST] Hello, I would explain that these spikes in blood pressure values could be related to the shots that he is taking.  From the other hand, his actual antihypertensive therapy does not seem to be really effective in controlling his blood pressure values.  For this reason, I would recommend checking first his kidney function tests and his blood electrolytes and then adding new Chat Doctor.  Hope I have answered your query. Let me know if I can assist you further.  </s>