Blood pressure management is a step by step approach, starting with a low dosage of one pill, measuring BP after a time, adding a new pill or upping the dosage of the first and so on. I started with frusemide and ramipril was the last to be prescribed. I was always told to call if I felt unwell before my next scheduled appointment. It is a bit of a suck it and see approach. Even the consultant admitted it when he told me that the ramipril was probably the drug doing me most good. Don't be afraid to tell them that the current regime isn't working for you. They already know that they might have to switch or alter dosage or whatever. They need your feedback.