uncontrolable high blood pressure

[Ruthie444]

Hello, I am very concern that I have uncontrolable high blood pressure, even with meds. It seems that they only work for a day of two, then the chest pain begin along with the bp of 160/100 to 175/115 i am very concern, i have been ordered some exams such as stress test, echo, and holter monitor but my insurance has not given an ok yet, meanwhile i have been in the ER twice this month for chest pain, shortness of breathe and bp within the range I just mentioned I am only 43 yrs old, i am not overweight, my blood work shows no problems all normal.  I was told two year ago that I have a Left ventricular thickening, and a diasolitc dysfucnction is this related or just something else happening,  i am very tried all the time, if i walk a short distance I am short of breathe, and i can not even lift anything heavy it makes things worst,  [Does anyone have an idea of what is going on? please help, I am very very worried.

[CCF HeartMD-2]

It is very unfortunate that your insurance company has not given the green light to proceed with testing.  Do you have a family history of hypertension?  Long standing hypertension can be a problem, affecting organs such as the brain, heart, blood vessels, eyes, and kidneys, among other things.  The fact that your echo showed left ventricular thickening suggests that your hypertension has been going on for some time.  Most people with hypertension require two or even more medications to control blood pressure.  In patients who either have hypertension at a young age or are not responsive to numerous medications, your physician may consider causes of hypertension such as renal artery stenosis (blockage of the kidney artery), pheochromocytoma, coarctation, thyroid conditions, parathyroid conditions, aldosteronoma, among other things.  This is not to scare, but rather to entertain the possibility of reversible hypertension which are treatable.   These can be idenitified with some simple physical exam, blood tests and ultrasound of the kidneys which focuses on the renal artery blood flow.  Your exertional shortness of breath may or may not be related to your high blood pressure, and I would certainly agree with your physician to get a stress test and make sure you chest x ray is normal and lung exam is normal.  
There are many classes of medications that can be used to control blood pressure, and I think that likely in your case, assuming there are no reversible causes as detailed above, you may end up needing 3 or even 4 classes of medications. It is important that these are taken regularly and on time.  It is also important that you remove all herbal supplements and alcohol for the time being, and make sure to lower your salt intake to less than 2000 mg per day.  Make sure to check all the labels on foods as there are some foods that hide lots of salt (i.e. processed foods, soy sauce, etc.).  There is also some literature regarding plant based diets with regard to their ability to lower blood pressure (See texts by Neal Barnard, M.D., and Cl Essylstyn, M.D.
It is important to treat your blood pressure soon so that you can hopefully reverse and arrest any effects it is having on your body.  
I hope I have been helpful, and best of luck.  I am sure you will get to the bottom of this soon.  With regard to stress, while it is easy for me to say, you need to try to relax as much as possible as this is certainly not helping with the blood pressure, but I understand you are nervous about what is going on.  

[CCF HeartMD-1]

The fact that one kidney was smaller than the other does possibly suggest that you may have something called renal artery stenosis (a possible blockage in the small kidney's main artery) so you need to be more formally evaluated for this once your insurance clears you.  It is ok to take a multivitamin but for now, however we would recommend no other herbal supplements or over the counter weight loss agents, or pseudoephedrine-containing agents which can elevate blood pressure.  

[Ruthie444]

thank you for responding right away.  to answer your question yes, both of my parents have high blood pressure and my father has had two heart attacks.  I have been on amlodipine, valsartan, hidroclorothiazide 5mg/160mg/12.5mg and this worked for about two weeks then my blood pressure starting rising again.  My last x-ray showed that my heart was enlarged on the left sid, my lungs looked good.I had a kidney ultrasound done about three years ago for a kidney infection, and the doctor said that my one of my kidneys was smaller than than the other, but that was it nothing was done nor was i told to do something for it.  I do not smoke,or drink I  have a no salt diet and no pork meat, i basically eat alot of fruits and vegs,  it is hard to exercise because of my shortness of breathe and chest pain. but i walk till it hurts then I stop, which is about 5 mins.  I do take multi viatimins, should I stop them? thank you for the information you gave me, i will begin my research and educate myself more . but if you have any more information please post me I will appreciate it very much,.  thank you once again.