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HIGH BP LOW PULSE RATE
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HIGH BP LOW PULSE RATE

BP GETS AS HIGH AS 194/125 ON A  REGULAR BASIS.NOW IT IS 167/100. PULSE RATE IS 43bpm. I SEE A DOCTOR WHOM PRESCRIBED DILTIAZEM 90mg X3 A DAY,METOPROLOL TARTRATE 25mg X2 A DAY.HCTZ 50mg X1. MY BP HAS BEEN AS HIGH AS 220/140. I HAVE NAUSEA,  "BUGGY ITCHY" EYES. CAN'T FOCUS.
MRI,CT,BLOOD WORK ALL COME BACK "NORMAL"
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Avatar_dr_m_tn
Hello,
You have very severe, uncontrolled hypertension which needs much better treatment!  Your heart rate being slow is reflective of two of the medications that you are on that block the atrioventricular node (conduction system of the heart); diltiazem and metoprolol.  Neither of those medications are good at controlling blood pressure.  A better beta blocker to use rather than metoprolol is carvedilol as it acts to lower blood pressure through a different mechanism than metoprolol.  A better calcium channel blocker to use in you would be amlodipine (rather than diltiazem) as it works to lower blood pressure much more effectively.  The HCTZ (hydrochlorothiazide) is a good blood pressure medication and would certainly be reasonable to continue as long as your kidney function and lab tests for electrolytes are ok.  If you have blurry vision, headaches, chest pain, or shortness of breath with blood pressure that high, you need to get to an emergency room ASAP!
There are many other medications and classes of medications that you could take to improve your blood pressure control (if you were my patient, I would put you on at least two other agents).  The longer that your blood pressure remains this way, the more damage it can cause to your heart, kidneys, and other organ systems.  You should see your physician again and reemphasize how high your blood pressure is (with symptoms of blurry vision!).  Hope that helps.
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