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DRUG RESISTANT HYPERTENSION

RESISTANT HYPERTENSION....It feels like I am the only person in the world with this problem and that there is no answer. In other words, I am feeling pretty hopeless, but mostly scared at this piont. I have had it all my life and I am 58 years old. I have had so many TIA's over the years, but recently, I had a small stroke in my brain stem.  . The Neurologist had no answer to offer, he  just walked out of the room after telling me that if I don't get it under control, I will die, or worse. I have taken a mountain of pills over the years that have not worked at all and I have followed the rules and nothing works. I refuse to give up. There has to be an answer somewhere from someone. If there is ANYONE that has a clue about this, I'm desperate at this piont and need help. I have adopted 3 beautiful little girls that no one wanted. I am more scared for them that for myself and believe me, I don't want to go out with a stroke.  Please, I need to hear from you.    MARLYNNE
8 Responses
367994 tn?1304957193
Is your weight under control?

The guidelines are published online in Hypertension: Journal of the American Heart Association.

You state taking multible medication so rule out any interfering drugs: Drugs that increase blood pressure, such as non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, should be withdrawn or reduced, if possible. An effective multi-drug regimen to reduce blood pressure is essential.

Diuretics: Reports from hypertension specialty clinics indicate that treatment resistance is often in part related to lack of or underuse of diuretics.

Mineralocorticoid receptor antagonist: An MRA can provide significant antihypertensive benefit when added to existing multi-drug regimens. In a small study of patients taking an average of four anti-hypertensive medications, adding a MRA lowered blood pressure on average by an additional 25 mm Hg systolic and 12 mm Hg diastolic.

Multi-drug regimens: “It seems most appropriate to continue to combine agents of different mechanisms of action,” the group wrote. “Thus, a triple drug regimen of an ACE inhibitor or angiotensin receptor blocker, calcium channel blocker and a thiazide diuretic is effective and generally well-tolerated.” Ultimately, however, combinations of three or more drugs must be tailored to the individual, considering prior benefit, history of adverse events, additional medical conditions such as chronic kidney disease or diabetes, and patient financial limitations.

Dose timing: Studies have shown that patients taking at least one of their anti-hypertensive medicines at bedtime had better blood pressure control—in particular, lower nighttime blood pressure.

Adherence: Steps should be taken to help patients take medications regularly and properly. Prescriptions should be simplified as much as possible by using long-acting combination drugs and once-daily dosing. More frequent clinic visits and home blood pressure monitoring will generally help patients adhere to their treatment routine. And, while an expensive and labor-intense option, a team approach to treatment including nurse case managers, pharmacists and nutritionists can improve treatment results.

Hope this gives you a perspective and iformation that may help.  Thanks for sharing and if you have any followup questions you are welcome to follow up

Avatar universal
Thank you so very much. It could be that the info you shared,just might have saved my life. My arteries don't need to get any harder and my heart certainally doesn't need to grow any thicker than it already has!  So, I am grateful for your response and I will share it with my MD.    Marlynne
367994 tn?1304957193
Marlynne, you are welcome.  Hope you get your blood pressure undeer control!
Avatar universal
I just wanted to let you know that I have had little success in getting high blood pressur under control on Lotrel and Diovan.  But I recently tried a beta blocker metoprolol and blood pressure was finally decent at the Dr. office.  It is usually high.  Sometimes it takes quite a few drugs to help.  I hope the best for you.
Avatar universal
The missing link for hypertension
It's not the salt--it's the sugar.
For years, the mainstream has been screaming that sodium is a leading cause of hypertension... even as they admit that they have no idea what causes 95 percent of all high blood pressure cases.
The latest study should clue them in, because it finds that the real problem may not be in the saltshaker after all. It's in your sweet tooth--and the more added sugar you have in your diet, the higher your blood pressure is likely to be.
Researchers looked at data on 4,528 Americans over the age of 18 with no history of hypertension, and found that those who consumed 74 grams of added sugars a day or more were 77 percent more likely to have of a blood pressure reading of 160/100.
And that will have your doctor reaching for his prescription pad faster than you can say "high-fructose corn syrup."
It doesn't take much, either--74 grams of added sugar is roughly what you'll find in two and a half 20-ounce soda bottles, and less than what you'll find in some of the cola buckets sold in convenience stores in fast food restaurants.
That's also roughly equal to 18 teaspoons of sugar--which is actually lower than the national average, since most Americans consume 22 teaspoons a day (and plenty of people take in a whole lot more).
It doesn't take a lot of math to see why a third of us have hypertension today--versus between 5 percent and 10 of Americans just a century ago, when people consumed much less added sugar.
The new study also makes perfect sense when you consider that lower blood pressure is one of the more immediate benefits of a low-carb diet, which contains no added sugar.
Better blood pressure is just one more reason why giving up the sugar habit is one of the best things you could ever do for your body. It may not be easy--added sugars, especially high fructose corn syrup, are in everything from soda to salad dressing and bread to barbecue sauce--but it's worth the effort.
One simple change can give you a taste of what's to come: A recent study found that just cutting out soda alone can shave a couple of points off your blood pressure. (Click here to read more.)
But the best reason of all is this: Lower your blood pressure on your own, and you won't have to be among the millions of Americans who take blood pressure meds.
Beets beat high blood pressure
Soda might raise your blood pressure--but there's one drink that may be able to lower it.
You might even say it can't be beet, because a new study finds that beetroot juice is just as effective at lowering blood pressure as nitrate pills.
That shouldn't be a surprise since beets contain high levels of natural nitrates, but a new study shows how quickly this simple juice can hit the bloodstream and go to work.
In three separate studies, researchers assigned healthy volunteers to either potassium nitrate (in doses ranging from 248 mg up to 1488 mg), potassium chloride, low-nitrate water, plain water, or 250 ml of beetroot juice (roughly 8.5 ounces of the dark purple punch).
The researchers took blood samples and blood pressure readings at the start of the study, and at regular intervals for the following 24 hours. And here's the root of what they discovered: The patients who were given 1488 mg of nitrate shaved about 7 points of their systolic blood pressure levels, while those who drank the juice lowered it by 5.4, according to the study published online in Hypertension.
The potassium chloride, low-nitrate water, and plain water had no impact on blood pressure, according to the researchers.
The study was done on healthy patients, but the researchers say there's no reason to believe it won't work for people who suffer from cardiovascular disease as well. But of course, talk to your doctor before you consider skipping your nitrate pills in favor of a glass of beetroot juice.
If you do give it a shot, you might want to start out with a blended juice (just make sure you have 8.5 ounces of beetroot in it). Beetroot juice has what some might call an earthy taste... which is a nice way of saying it tastes like dirt. By adding some carrots, tomatoes or berries, however, you might be able to make it a little more palatable.
Beetroot juice has long been believed to have beneficial effects on the bloodstream. It's also a good source of the dietary silica needed for healthy bones. And another new study finds that a glass a day may even boost your stamina by up to 16 percent.
plus 3 cups per day of Hibiscus tea can lower BP
Avatar universal
Thanks for your post and encouragrment. I take the 100mg metoprolol 2 times a day along with clonidine & enalapril. I am going to ask my MD about a diuretic and MRI as info from kenkeith advised. I am really glad your pressure was down at your last visit. Do you take Plavix?  
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