<s>[INST] I had CABG 18 years aback. Nowadays when tested I am found to have Supra ventriculare Ectopics and Blood pressure in the range of 160/80. I am taking Cresar AM twice a day,  concor 1.25 mg daily. still i find my BP remains to be 160/70 most of the times. Please advice? [/INST] Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. As you explain, you had CABG years ago. As you are diagnosed with ischemic heart disease, this means that we should be very careful with hypertension, because high blood pressure values slowly modifies your heart muscle. The ectopic beats have to do with some electrical issues in the heart. Some electrical impulses that generate in a part of the heart different from normal sinus rhythm cause a premature heart contraction that you feel like a skipped beat, because it's not a normal one. There are different factors that might cause this skipped beats like emotional stress, excessive coffee consumption, coca-cola or energy Chat Doctor. Pathology like anemia, hyperthyroidism or ischemic heart disease might be other causes. You explain that you still have high blood pressure values despite your treatment. So, if you have mean values above 140/90 mmHg, than we should definitively correct your treatment. We can do this in two different ways. Raising the dosage of your existing medications or adding another  </s>