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Acute severe hypertension caused by partially blocked kidney stone?

I'm a 47 year old hypertensive male.  Quick hypertension history:
25-35 years old: normal/high blood pressure, 135/85
36 years old: 140/90, official hypertensive diagnosis
36-43 years old: many meds tried, no medicine significantly brought down blood pressure, but gave bad side effects.  
44 years old: lost weight, from 230 to 205 pounds, blood pressure dropped to 135/85, stopped taking meds

I now weigh 195 pounds and until recently my blood pressure has been in the 130/80 range and I've felt great. I don't smoke, sleep well, eat well, take long walks with my dogs, lift weights, life is great.  I have a cup of coffee in the morning and a shot of whiskey and a beer at night, my only vices.

I gave blood at the red cross two months ago, I give every two months.  Blood pressure was normal at that time. Then I go to give blood early last week and it was 160/106.  Whoa.

Talked to my primary care doc, and the readings were confirmed, but she didn't prescribe anything as I have a shaky history with any med working. She just had me monitor at home.  Since then I'm getting readings typically about 177/112, with some readings into the 190/120 range, but some lower around 160/105.

A nurse friend made me go to the ER over the weekend she was so worried when it stayed over 185/115, but since I wasn't having organ failure, they just gave me a single 0.1 mg clonidine and sent me away.

I saw my urologist on Monday for a followup to the kidney stone event I had last year.  I had a small stone pass back then and on x-ray they saw a 4 mm stone sitting in my right kidney, so I had a scheduled follow up to check on it.

The stone has moved to my ureter and has gotten stuck, about halfway.  I've been feeling significant pain on that side since the end of December, but I had a kidney infection which was treated with ampicillin at that time and thought it was all related to that.  Oh, my blood pressure at the end of December was slightly elevated (148/92), probably due to the PSGN (it was strep bacteria in my kidney, which causes elevation).

Now I have a partially, maybe intermittently fully blocked ureter.  My right kidney showed mild enlargement, but kidney functions are normal.  The urologist prescribed Cardura to help open up the ureter to pass the stone, and it also lowers the blood pressure about 30/20 points for a few hours.  Been on it a couple of days now.  If in 3 weeks it hasn't passed, they'll remove it surgically.

I'm also getting nausea, palpitations, nervousness, sweats, cold intolerance, racing pulse, irritation, etc., and have been since early January.  .

So..... my question is, can a blocked ureter cause a very high spike in hypertension like I'm seeing?  

I mean, I've basically gone from normal-high to acute severe hypertension in about 2-3 weeks.  Nothing about this seems right and I'm very concerned.

3 Responses
Avatar universal
Hi there. Firstly I am not a doctor, but will try help you with my experience. Usually doctors will harp on regarding your weight as a cause of high BP. You have made great progress to get it to 195 lb, but more would be needed. Indeed there are a number of causes of secondary Hypertension. Any problems with the Kidneys can cause it to rise. Do you take any other meds? I also feel reading your post that this episode is stressing you a bit. That is certainly going to cause a rise too. But it seems like you are having a jump in BP for some reason. I would query Adrenal gland problems? Its just that Aldesterone problems can cause big spikes in BP. Sometimes there can be tiny adenomata on the Adrenals ( Known as Conns Syndrome) that can be difficult to detect due to their small size. This problem causes resistant Hypertension, difficult to lower with BP meds sometimes. Its rare enough, but definitely worth a look. It can be checked by Blood work or Pet Scan(Expensive test). It is also sometimes noted too that your BP fails to drop at night, . When normally it would dip , it may stay the same or even go up ( This happens me). It is said that night increases can be a marker for secondary causes  I just wonder what type of tests / investigations you have had? Have you had a 24hour ABPM test? This is important to get your 24 hour averages and should be done. Hope this helps, keep us posted
Thank you for the reply!

I'm not certain my weight is much of an issue, since it and my blood pressure were stable for so long, and in under a month I have a 40 point increase in systolic pressure.  Doesn't sound like a lifestyle change.

I looked into issues with the endocrine system being behind my issue, including Conn's syndrome, and I agree, it looks more likely to be coming from that, and maybe not a blocked ureter.

I haven't had any hypertension diagnostic tests done, even though I've seen 3 doctors, and even visited the ER over the weekend.  The docs are basically sitting on their hands and just having me monitor my blood pressure at home and send them the data every week, even when I have days of 190/120 blood pressure, they don't seem alarmed by it.

I think I'm going to make an appointment with an endocrinologist.
I forgot to say.  My morning readings are the second highest of the day.  Highest are when I'm active and at work during the day, and the lowest are at night.
Avatar universal
I have to say I am a bit surprised you have not had a 24hour ABPM. Its a simple test, even the bigger Irish pharmacies offer the test for 5 euro!. Its advisable. Lower BP at night is a positive. Higher early in the morning is normal too as BP usually spikes a little then. Its something to do with the Circadian rhythm I believe.
Its common to have Bp meds introduced promptly when there are a number of readings over 160? Also have you had an Echo? If so find out what your EF was.(Its a percentage figure) Some of the adrenal tests are a little complicated, and yet no 24hour ABPM. What bloods were done? any Plasma Renin level test? What are your blood sugar levels?
Normally resistant hypertension requires either tinkering with meds to find a working combination or investigation for root causes. Its a surprise that the doc would not work on med adjustments and prescribe  that no meds are your answer!! Strange., I  have resistant Hypertension myself and at one point was taking 12 tabs a day. Even on those (Including 8mg  Cardura) it was still over 180 !!
I eventually was prescribed a 4th line BP Steroid drug and it went down to 100 !!  The drug is prescribed for a number of conditions including CHF, Acne and BP. There are side effects that are horrid. Its called Spironalactone. Im not suggesting you need this drug but wanted to explain my experience a little. For Adrenal Issues there is a really good guy in Cambridge University in London. It is Maurice Brown. He has done lots of studies and his work is well worth reading
I dropped off my weeks data log to my primary care doctor last night.  Today they called and said they just want me to monitor for another two weeks.  I was prescribed a drug for my stuck kidney stone, to open the urether (Cardura 4mg), but it also lowers BP, but usually just a little.  I don't anticipate any significant reduction.  Considering I'm 40/30 points higher just in this month, I don't expect much that Cardura by itself can do.

I had a complete cardiac workup done 10 years ago when I was first diagnosed with hypertension.  Two years ago I had an arrythmia brought on by a panic attack and had another workup (echo, stress test, calcium score, etc), and I was in perfect cardiac health, again.  My calcium score was zero, for example, which is rare for someone 45 years old.

10 years ago they were jumping all over me to try all these meds and combinations of meds.  And that's when my BP finally became 140/90 consistently.  Now that I'm approaching 180/120 consistently, they're doing nothing.  No blood tests, no urine tests, no 24-hour BP monitoring, nothing.

Why the change in attitude?  Who knows?  When they tried to control it 10 years ago we went through maybe a dozen meds, and none really worked (except lisinopril, but I got the bad cough).  There's still dozens more they could try.

Can't be insurance.  I have a $6,000 deductible, so I'm paying for it all so far, and I've told the docs I already have the money in savings and am willing to spend it.  So cost savings isn't an issue.  Maybe they're worried about making a mistake and getting sued?  Seems doing nothing is just as risky.  Then again, I have no family, so if I die, there is no lawsuit.

I know about spiro.  For men they prescribe eprenelone instead so that gynecomastia and ED don't happen to them.

Avatar universal
Hi, this is actually PepperJeff responding to my own thread.  I can't remember my password for PepperJeff, so am using an old login


I had shockwave lithotripsy a month ago.  Seems that blocked stone had gone fully blocked and I developed hydronephrosis (enlarged kidney) sometime from January to the end of April when they did a followup.  Don't know how long it lasted or if there is permanent damage.  During January to April my blood pressure was still spiking, even on 12 mg Cardura daily.

After the shockwave lithotripsy my blood pressure dropped the next day to 122/80.  Basically stayed there for a couple of weeks as I passed the chunks of stone.  So I do think my blood pressure problems were caused by the kidney stone.

About 10 days ago I started having elevated blood pressure and was having very mild flank pain at the same time.  Urologist did an x-ray but didn't see anything.  I think I may have a uric acid stone causing a blockage, and raising my blood pressure.  Uric acid stones are invisible to x-ray.

I can't get in to see my urologist until August.  Thinking about just treating myself to large amounts of citrate in my diet and measuring urine pH to see if I can dissolve any uric acid stone that's in there and see if my BP comes down.

I just want everyone to know, if you start having unusual elevated blood pressure, get checked for kidney stones.

I never really had bad stone pain during the 4 months that bugger was lodged in my ureter.  Those are called "silent stones".  Not all stones cause pain, and sometimes they can cause blockages and resulting elevation of blood pressure and eventually kidney damage.

So don't settle for a doc just throwing pills at you to bring your blood pressure down.  There may be another cause.
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