Three hypertension meds and still getting high readings.

  I am 37 years old and currently taking tenormin 100mg daily, zestril 20mg
  daily, and hydrochlorothiazide 25mg daily and still struggle with high blood
  readings.  My doctor wants to keep me on these meds for another month and
  then come back and see him.  I have been on tenormin for 7 years, zestril for
  3 years, and hydrochlorothiazide for 10 months.  I have a family history of
  hypertension, heart disease (father and mother suffered strokes, father had
  bypass surgery in Sept. 97 following 2 heart attacks)and diabetes.  If my
  high blood pressure doesn't go down, what should be the next step in treatment?
  I had a EKG done in June 98 and it came back normal.  My readings vary from
  140-160(top no.) to 88-110 (bottom no.)  Sometimes higher when I am feeling
  sick and too much stress.  I also had blood work done and I have high cholesterol.
  I try to eat right and walk and working on losing weight.  What else can I
  do to improve my hypertension.  Lately I have been feeling lightheaded and
  nauseous and getting more headaches than usual. Could this be from the meds?
  Also can your body build up a tolerance to meds over the years?  Thank you
  for your advice and suggestions.  
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Dear Maria
You should eliminate salt from your diet. In some patients this step makes their blood pressure much easier to control. You should also not take ibuprofen (found in Motrin or Advil); that whole class of medicines, called non-steroidal anti-inflammatory agents, can contribute to high blood pressure. Many nasal decongestants can contribute to high blood pressure. You should avoid alcohol and tobacco. If you are overweight, just losing 5 to 10 pounds can make a big difference.
Of course, you should take your medicines every day and not skip doses. If you are taking certain herbal medicines, these can sometimes cause high blood pressure also.
If the above measures don't work, you could be started on a fourth blood pressure medicine. Before doing that, I would make sure you do not have a rare cause of high blood pressure that would be treated surgically or kidney disease causing high blood pressure. Your doctor should know which tests to order to rule out the causes of secondary hypertension.
I do not know what could be causing your headaches. Sometimes if blood pressure is very elevated it can cause headaches. Lightheadedness could be caused by blood pressure being too low.
You do not build up a tolerance to these medicines over time.
I hope this is useful. Good luck. Feel free to write back with further questions.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15. Information provided in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your doctor.