My reply to your question about why a nephrologist didn't get through, so here it is: Nephrologist is the first choice under the protocols of my HMO, because the kidney – more than any other organ (except the brain) – controls blood pressure. In my case, I had two nephrologists work on me. The first used the medically popular approach of testing a succession of medications in search of a combination that would control my BP with few adverse side effects; after reaching a point where I was taking huge loads of potassium sulfate pills each day, I asked for a second opinion. My second nephrologist took an approach I had hoped for – extensive testing in search of the cause of my hypertension, with the help of an endocrinologist who tracked the influence of several glands and their hormone output. She found an inherited malfunction of my kidney – first, reclaiming sodium the kidney had removed, then failing to reclaim potassium it had removed. On that basis, she prescribed a medication that is rarely used these days; it is a potassium-sparing diuretic. I may not be quite accurate medically, but I feel confident unofficially that low potassium was not the result of high BP, but BP was the result of low potassium and reclaimed sodium that kept water levels too high in my tissues.

Thank you for your reply. It has been long since that I have wanted to<br>research the origin of my hypertension. Though my current medication<br>regimen is doing a pretty good job of keeping my BP in check, I'm almost<br>some what forced to keep it the way it is for the fact that they are<br>working. I'm currently taking losarten 100/12.5, propanolol 10mg at around<br>noon and 2.5 mg amlodipine in the evening to maintain a 24 hr med level<br>around the clock. I also take 112 mcg levothiroxin in the a.m. And<br>buproprion 100mg which I don't think I really need. I am looking for a<br>specialist to help me re-evaluate my med intake. One doctor said I was on<br>too many bp meds, that I needed to get of the toprol 12.5 I was taking at<br>the time. That was a trip after taking it for so long. I did get off it<br>little by little. Then after an incident that landed me at the ER because I<br>was off the toprol for a couple of days combined with a couple of drinks<br>too much ( and I truly mean a couple drinks) my htn went sky high and with<br>all the symptoms that go with it. After seeing a cardiologist he put me<br>back on propanolol, not only does it help with the bp but it has a sort of<br>calming effect on me that helps with my anxiety. So, that's where I'm at<br>right now. As soon as my insurance kicks in from work, my goal is to<br>resolve all this. If any suggestions plz advise. Thx for listening.<br>Mike.....<br>

I repeat my earlier recommendation that you find a good nephrologist to help with the review of your meds. Your first question to her should be, “Am I over-medicating my BP?” I'm familiar with your current regimen, although I don't use it. It has some good facets.