<s>[INST] PLEASE PLEASE HELP. FOR 3 DAYS A MALE IN HIS MID FOURTIES WITH A HISTORY OF HIGH BLOOD PRESSURE HAS BEEN WAKING UP COMPLIANING OF NAUSEA AND SWEATING. HE WENT TO THE EMERGENCY ROOM AND THE GAVE HIM A POTASSIUM PILL, BUT TODAY HE COMPLAINED OF IT AGAIN. HE HAS A HISTORY OF HIGH BLOOD PRESSURE, BUT A NIGHT AGO, IN THE EMERGENCY ROOM HIS HEART BEAT WAS AT 53. WHICH IS GOOD. HE EXCERCISES, BUT CARRIES A LOT OF WEIGHT IS HIS ABDOMINAL AREA. WHAT SHOULD WE DO? [/INST] Hi,How much was his blood pressure during sweating episodes, was it too high? Possibilities are, there can be excessive rise in BP which is causing his symptoms. Secondly it may be due to slow heart which may be very low during sleep leading to symptoms, is he on any beta blockers or drugs which decrease heart rate. If yes, it should be stopped. Also one thyroid tested is needed. If both of above is negative then he may need holter monitoring. Also his troponin and ecg is must.  He should follow healthy lifestyle like avoiding  fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure and pulse rate regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 minutes a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity. High risk activity like driving should be avoided til diagnosis is confirmed.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode </s>