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    Old 06-05-2008, 06:08 PM   #1
    richene43
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    Question Severe high blood pressure

    I am 65 years old and have type 2 diabetes and high blood pressure that has been controlled for many years with drugs. This early part of the year my pressure started to rise steadily till it has reached 236/120 at one point. My doctor has tried to regulate it with different meds but nothing is working. I use to get good control with calcium channel blockers but am allergic to them now. She now has me on Lisinopril 40 mg twice a day, Metoprolol 50 mg in the evening and 100 mg in the mornings and Hydorchlorithizide 12.5 mg twice a day. I take my pressures 4 times a day and they are improving some but generally are 200/100 every morning and near that in the afternoons. I suspect that my kidneys are involved even though my labs are within normal range. My urine test came back slightly abnormal...they didn't tell me the numbers. I suspect Interstitial nephritis due to taking acetaphenamin in somewhat large doses in the fall of 2007 and winter 2008 , 1000 mg every night and occ during the day. The other thing that could possibly be causitive could be the adrenal glands over production of aldosterone or even a tumor. Has anyone out there experience such high blood pressure and had an resolution to it? I am 5'1" and 182 pounds. I have lost 30 pounds the past 3 years and still losing. My diabetes is well controlled with a A1c of 6.2-6.5. Thanks

     
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    Old 06-05-2008, 09:52 PM   #2
    flowergirl2day
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    Re: Severe high blood pressure

    Hi richenne,

    Sorry to hear about your tough-to-control high blood pressure. Could you have developed a drug resistance over a period of time? Developing an allergy to a drug after years of use is not unheard of. I had that happen to me not long ago, after being switched from a brand name to a generic CCB. I found I could not tolerate the generic at all. Sometimes changing a brand of a drug leads to problems.

    As you suggest, the hormonal or renal causes of your unexplained high blood pressure seem likely. Unfortunately, the labs can remain perfectly normal in some kidney disorders. What does your doctor think? The severity of your hypertension calls for an aggressive therapy and some drastic measures. Your meds should be reviewed since they are not effective in their current combination and dosing. Your blood pressure must be brought under control. I hope your doctor orders appropriate tests and blood chemistry workup that might help identify the underlying cause of your blood pressure elevations. Have you developed any new symptoms recently or started any new medications? Were you able to attain and maintain your blood pressure targets in the past?

    You sound like a good candidate for a referral to a hypertension specialist. Don't wait too long.

    flowergirl

    Last edited by flowergirl2day; 06-05-2008 at 10:02 PM.

     
    Old 06-06-2008, 02:35 AM   #3
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    Re: Severe high blood pressure

    I had similar problems with my b/p plus lots of serious drug reactions. I saw two b/p experts & finally settled on taking 25mg dye free HCTZ & 1800mg if Labetalol which is an alpha/beta blocker. Labetalol can elevate blood sugar in some people, but I haven't had a problem. I do exercise a lot though which I think helps. Lebatalol is a drug often used in the ER for patients who come in with severe HBP so you may have already gotten it. Good luck. I waited much too long in switching DR's; I hope you don't. Fam

     
    Old 06-06-2008, 02:32 PM   #4
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    Re: Severe high blood pressure

    Thank you for your input. I have been looking at the alph-beta drugs and wondered if they might be good to try. One thing I am doing is taking baby aspirin nightly which is new. I have been taking it 2 weeks now and today my pressure is beginning to lower significantly, 140/80 at one reading today. I live in a cold region which is still cold despite being June. I figured that the blood thickens in the winter so therefore it might present higher pressure. I am reserving opinion on that till I see more long term effect. I believe you may have something on allergies. I have never been allergic to the calcium channel blockers before but now I break out in an almost total body rash. I'll mention the alpha-beta blockers to my doctor. Thank you

     
    Old 06-06-2008, 02:42 PM   #5
    richene43
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    Re: Severe high blood pressure

    Quote:
    Originally Posted by flowergirl2day View Post
    Hi richenne,

    Sorry to hear about your tough-to-control high blood pressure. Could you have developed a drug resistance over a period of time? Developing an allergy to a drug after years of use is not unheard of. I had that happen to me not long ago, after being switched from a brand name to a generic CCB. I found I could not tolerate the generic at all. Sometimes changing a brand of a drug leads to problems.

    As you suggest, the hormonal or renal causes of your unexplained high blood pressure seem likely. Unfortunately, the labs can remain perfectly normal in some kidney disorders. What does your doctor think? The severity of your hypertension calls for an aggressive therapy and some drastic measures. Your meds should be reviewed since they are not effective in their current combination and dosing. Your blood pressure must be brought under control. I hope your doctor orders appropriate tests and blood chemistry workup that might help identify the underlying cause of your blood pressure elevations. Have you developed any new symptoms recently or started any new medications? Were you able to attain and maintain your blood pressure targets in the past?

    You sound like a good candidate for a referral to a hypertension specialist. Don't wait too long.

    flowergirl
    Thank you for your response. I could possibly be reacting to generic. My doctor is trying varing doses of meds she put me on last summer -increasing them with each visit to her and I have taken different generics from different drug companies so that complicates things a bit. Are you talking about a Cardiologist when you speak of a hypertension specialist? This is a good suggestion and I am going to consider getting an appointment.I am not happy with my doctor in that she just doesn't seem concerned enough about how high my pressure is. Thank you for your response . I'll post my progress as it happens

     
    Old 06-06-2008, 09:27 PM   #6
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    Re: Severe high blood pressure

    Sounds good.

    Hypertension specialist can be any type of a doctor with extra training in hypertension. They have to be certified and complete a program. Many are cardiologists or kidney doctors, because their specialties are so profoundly affected by blood pressure. They can also be internists, family physicians, endocrinologists etc. These specialists deal with a lot of people with various types of blood pressure problems. All of their patients have hypertension that is difficult to manage, drug resistant, or refractory. Often, all it takes to normalize blood pressure in these people is a change in medication - the number one thing that gets checked out during an initial visit. One can feel confident about receiving an optimal blood pressure treatment after a medication review and adjustments to the drug therapy.

    While experimenting with various antihypertensive drugs is fine and the only way to find out which drugs give the best control, it is not acceptable in a person with severe hypertension for an extended period of time. Your current blood pressure - 140/80 - is not bad at all... Let's hope it stays that way. I hope your doctor stops switching the meds.

    flowergirl

     
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