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ashby1947 (@ashby1947)

Resistant Hypertension

Heart & Blood Health | Last Active: Jul 16, 2020 | Replies (5)

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@ashby1947

Hi Martin – Thank you for taking the time to respond. I am heartened that you said my average systolic of 151 did not alarm you. I still don't know what to think about all of this. I am waiting for a further response from my Cardiologist. Since all my kidney tests were negative, I doubt that I will see the Nephrologist again. I am on Cardedilol 25 mg TID, Telmisartin 40 mg BID, HCTZ 12.5 mg morning, and Diltiazem 180 mg evening. Clonidine 0.1 mg was my as needed drug until I spiked, controlled it with oral Clonidine, then rebounded to LBP the next day, and very high the day after that. Subsequently, I am on Clonidine patch. It seems to be effective; however, my BP is still high. 3 of these have been added in the past few months. Sorry so much information. I am struggling with an exacerbation of my lumbar back issues right now and in acute pain – which no doubt contributes to the HBP. That will be resolved soon with injections….. until the next time. I think I still have vestiges of 120/80 hovering over me, and the next conversation with my Cardiologist should provide me with a more realistic outlook for someone my age, experience, and medical history. The uncertainly of if/when my BP will be out of control again haunts me, even though I have meds here to deal with it, and I know my way to Mayo ED well. I am trying to keep my focus on this from an academic perspective. How long did it take you come to the stability that you now experience? Was there anything in particular that you found helpful in dealing with your road to feeling confident in your situation? with the doctors? in your own life? I would appreciate anything you care to share. Sue

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Replies to "Hi Martin - Thank you for taking the time to respond. I am heartened that you..."

Sue (@ashby1947), It's interesting that your medications are numerous and somewhat high dosages. I regard myself as a victim of resistant hypertension, as you know. My meds treating hypertension include Carvedilol (25mg BID), Lisinopril (40mg), and a diuretic Amiloride (10mg BID). My as-needed standby is Hydralazine (25mg). For me, this is heavy stuff. I once forgot Lisinopril at night, took it with Carvedilol in the morning, and wound up in the emergency room after fainting in church! Over the years, I have taken a dozen other hypertension meds, and now my medical team treats most of them as allergens — including Clonidine (a sophisticated brain agent), Diltiazem, and Hydrochlorothiazide on your list and Lasix, which once sent me to the ER for hypokalemia (lacking potassium).

How long have I sought stability? Forty years in Northern Virginia, from an Internist with cardiology credentials, three PCPs in a large clinical practice, three cardiologists, and two nephrologists — the last of which is a genius devoted to finding causes, not just treating symptoms. Her use of an endocrinologist to examine all of my relevant hormones cracked the case! Over the years, I usually felt confident of my medical team, not because they solved my problems, but because they tried alternatives until I reached a stability of sorts. I turned a corner 20 years ago when my new clinic diverted me from Cardiology to diagnosis and treatment by Nephrology. That started a string of second opinions initiated by my doctors with my cooperation, because of the new focus on finding a cause. Diet and exercise changes have cemented the therapies into my outlook which remains positive at age 85. Could you have Mayo provide second opinions on your current medication regimen? Martin

Interesting that you mention back pain. I had severe back pain (avg pain score steadily climbing to nearly 10) for several years. Had 2 major fusions (now hairline to hips fused, only 3 top vertebrae not fused). Drastic, but BP – which had been similar to yours) is now normal and off BP meds for 2 yrs, despite increasing weight. I’m 70. Only known difference has been pain resolution. Hugs and best wishes!