Resistant Hupertension

Dear Doctor,

I am a white 46 year old male who was diagonosed with hypertension in 1994. Since that time I have been a variety of drugs including diaretics, ACE inhibitors, Calcium Channel Blockers and Beta Blockers. I am currently taking Atenolol 50 mg, Felodipine 10 mg and Maxzide 25 mg, and have yet to be controlled for more than 2 months (lower than 140/90). I also am taking Colestid 4 gr x 2 day for High Cholesterol (HDL 59, LDL 153). In 1995 I was admitted to a German hospital with a BP reaction to prescribed Motrin, whereupon I was tested with: 24 hour BP check, ECG, abdominal ultrasound, stress test and a Farbdoppler ECG, with no out of ordinary results.

I have recently been tested again with a renal ultrasound and 24 urine test for a renal tumor with negative results.

I am about to retire from the military and would really like to get this under control. I have a consult with a cardiac specialist at the end of the month. What should I make sure he looks for?

[Cleveland Clinic, MD]

It sounds like most of the "secondary causes", that is potentially treatable causes of high blood pressure (HBP) have been excluded and therefore the diagnosis of "primary or essential HBP" can be made.  Therapy with a single drug sounds like it will not work for you therefore you will need at least two medications.  The cardiologist can recommend which two and then increase these to maximum doses.  In addition lifestykle changes are essential!  Good luck.