Hi, @evittan. I hope you can get a handle on your diastolic BP with the help of a doctor who cares. My experience includes some issues to consider as you look for a second opinion about your situation. My HMO set me up intelligently, sending me first to a nephrologist, (kidney specialist), and that turned out to be a wiser choice than trooping down the list of available cardiologists. In my case, the nephrologist partnered with an endocrinologist to examine whether hormones might be involved in my hypertension.

Of special interest to them was my adrenal glands which produce adrenalin and cortisol -- both of which inspire responses in a variety of organs and functions, for example, the heart, arteries, and brain. They focused on cysts on my adrenal glands which might be generating excess hormones that pressed my heart to respond as though I was in anxiety or fear. That turned out not to be the case. But they did come up with a rare condition in my kidneys -- the Lyttle Syndrome, a genetic problem that drains potassium from my blood and reclaims none of it, leaving me hypokalemic, with raised blood pressure. A few months later, my cardiologist diagnosed my atrial fibrillation which interferes with the function of my heart, causing another BP problem.

From this experience, you can guess why I am glad to have had a multi-physician medical team -- supported by my personal care provider (PCP) and consisting of nephrologist, endocrinologist, cardiologist, and pharmacologist (with incidental support from a neurologist with expertise in the brain's influence on hormones). Costs? Medicare took care of the main costs, and my HMO settled for $130 a month, plus a few hundred dollars a year for medications. Perhaps my adventures will give you some ideas for broadening your medical care and bring other experts to your treatment team.

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