Sudden and severe rise in BP

[Shartay]

After a lifetime of lower than average blood pressure (90/60) and virtually no headaches, in the last two months I have developed high BP and a constant headache. Doctor visit for headache found BP at 150/93. Coreg/20mg was prescribed.

After a week BP dipped very slightly, and Coreg/40mg was prescribed. Results were not much better.

The ache is “whole head” and in back of neck. It’s a little better in the morning but gets worse through the day, correlating with BP going as high as 161/90. It feels like there is too much fluid in my head. Need two pilllows at night to keep head elevated.

A recent MRI stated: “White matter changes, likely the sequelae of chronic microvascular ischemia. Hyperintense T2 signal within the mid pons may also be related to chronic arteriolosclerosis. Central pontine myelinolysis can produce similar imaging findings.”

I am not aware of  having had any mini-strokes, and no one in my family has ever had this. What else could  cause my headaches and high BP?

[Shartay]

Thank you, Vanessa. It's comforting to have an expert opinion.

If you have time to shed a little light on this, I would appreciate it. After two weeks on Coreg and just a small decrease in BP, I took 20mg Benicar this morning (10mg four hours apart), and my BP went down to 98/60 (normal for me). My headache all but vanished, and I feel limp as a dishrag.

Why did Coreg not hit the mark, while little-known Benicar did? Is this an indicator of the cause of my high BP and headaches?  Thank you.

[Vanessa Lacuesta]

Hi,

I suggest that you have a proper work up done. Blood pressure may increase secondary to a lot of factors.Heat,pain and stress may increase one's blood pressure.However,once these factors are removed,the BP is expected to convert to its normal baseline level.For persistently high BP ,one has to exclude cardiac problems, kidney problems,hormonal problems, water retention,electrolyte imbalance,the presence of nerve related problems,an underlying systemic medical condition ( increased blood thickness or viscosity, hypercoagulable states).

I suggest that you have  a complete work up done. An EKG, 2D ECho of the heart, carotid duplex scan of the neck vessels, a TEE to rule out a patent foramen ovale ,determination of kidney function, a 24 hour urine collection, coagulation factor levels,thyroid hormones,serum sodium levels may need to be determined.

Watch your diet.Decrease salt intake and exercise daily.Brisk walking for 20 minutes at most days of the week may be beneficial.

I suggest that you be evaluated further for your condition. The underlying cause of the increased BP has to be ascertained.Also discuss with your physician the need for anticoagulation therapy at this point .