What tests do I need for BP?

[grannyheart]

Had heart attack, valve replacement,,heart failure in 2007. Since then with ups and downs been doing okay. Starting a week before Thanksgiving my blood pressure started going up and became resistant to lowering with the drugs was taking....100 cozaar...25 aldactone.....25 ToprolXL.  Numbers were running 210/110 and seemed to hover in that range.....saw dr and he put me on 50 hydralazine which has lowered it to 175/180 over 90...feel pretty wiped out...the hydralazine seems to have given me lots of side effects but if it works to lower bp I'm okay taking it. My cardiologist said that if the addition of hydralazine didn't do the job then perhaps tests would be needed.  I do take 20 Lasix every other day..............what types of tests are needed for this?  Is it just a matter of finding the proper drug combination?  I need to get this settled as I feel like a ticking time bomb with numbers running this high........I'm 78.....thanks for any input!

[sunil930]

hi..my father had an post asd closure and mvr...he underwent operation on april 5th 2013...he recently took 2d echo...it shows that RA and RV are still Dilated and TR+/MILD PAH and also MILD PR...and also aortic valve is calcified and AORTA size is 3.2cm..ESD=3.10cm,EDD=4.85cm,,EF=65%,PW=0.91cm,IVS=0.84cm..FS=36%.and  also left artrium is 3.8cm..we are very scared he may get HEART attack...His age is 50years..plzzzzz say how is the present condition...and we see that there are irregular heart beats...i dunno why there are irregular heart beats..plzzzz answer my question :)

[grannyheart]

Thanks for your input....this rise in BP is definitely a new thing....no change in any meds etc.....I have felt that perhaps my kidneys may be developing problems based on my last blood work that was over a year ago. Both BUN and creatinine were more elevated than I would like but was told to not worry about it. As for palpitations....have had those for years and that's why the beta blocker.....occasional flushing/sweating.(this seems to come and go) I don't have a apt with my cardio until April but plan on calling if my BP doesn't get any better.....was waiting to see if the hydralazine works.....but the side effects are making me feel so bad I wonder if it's worth staying on it. My body two years ago seems to have developed a adversity to any new med I'm put on......previously could take anything ad never noticed too much in terms of side effects.................this is the third drug that has caused lung issue (bronchospasms)
   Sorry to be rambling on here................thanks again............

[CCFCardio MD2]

Hello and Happy New Year!  I'm sorry to hear you're having trouble.  If you had a sudden change in your blood pressure without changes in your medications, your doctor may need to evaluate secondary causes of hypertension, such as renal vascular disease, pheochromocytoma, or primary aldosteronism.  These are rare causes of high blood pressure and you may just need an adjustment in your medications, but further workup may be warranted.  If you have no symptoms such as palpitations, sweating, flushing, your doctor may start with some kidney function labs and perhaps an ultrasound of your kidney arteries.  Hope this helps!