Prolonged Use of Combo Cause Blackouts?

After my blackout, the Dr. immediately discontinued 2/3 of Atenolol, Hydralazine, and Doxazosin. My suspicion and question: Could the prolonged use fo so much of the combinations have caused a blackout, which resulted in a broken nose, shattered dentures and biting 1/3 of my tongue off.?

A series of blackouts occurred about 1 1/2 yrs. ago after starting a new BP med and they immediately discontinued it and admitted it was the cause. This time so far, mum seems to be the word. I am tired of being a test pig and paying with injurioes.

[Sandra Y, RPh]

After review of your medications it seems as if you were being treated with 5 different types of medications to treat your “moderate” blood pressure condition none of which were maximized on their dosage before adding another agent. The usual goal blood pressure is less than 140/90mmHg (Systolic pressure on the top and Diastolic pressure on the bottom) unless there are other health conditions to take into consideration (heart problems, diabetes, etc.) in which the target blood pressure goal is lower. The usual procedure is to start a patient on a single agent and slowly optimize the dosage and monitor for side effects. If there are no side effects experienced by the patient and the goal blood pressure is not reached, then a second agent can be added. However, blood pressure control is different in every patient and your physician may have had very specific and valid reasons for adding each of the different medication classes because each has its own separate benefit from the other drug classes. The four mentioned medications that were being used to treat your high blood pressure were: Atenolol (a beta blocker), Doxazosin (an alpha 1-agonist [vascular dilator]; also used to treat enlarged prostate symptoms), Hydralazine (a vascular dilator), Hydrochlorothiazide (a diuretic), and Losartan (an angiotensin receptor blocker). Again, each of these medications is used to treat high blood pressure and have different ways they work in the body to help reduce blood pressure. Additionally, all medications that reduce blood pressure can cause the potential side effect called orthostatic hypotension in which upon changing body position (getting up from lying down, sitting to standing, etc.) your blood pressure can drop and not enough blood can reach the brain and you can feel lightheaded, dizzy, and some patients can black out. This side effect usually disappears once your body becomes acclimated to the change in blood pressure after a couple of weeks (but can return if a dose is increased or a second medication is added). I would consult your physician about your therapy and your concerns and go over which medications should be kept on for your blood pressure control and which can be removed.