High Blood Pressure Not Responding To Meds

I have been going to the Cambridge hypertension unit every 6 months for the past 2.5 years.  They require me to obtain averages of AM plus PM blood pressure measurement figures below 135/85.  Although I can get average results close to these, the results during the day, and the PM figures, vary appreciably around the 2 means.  They say this does not matter.

Can you give me a website details so that I can read about the Oxford study please.

Is that the Hypertension Referral Centre at  Addenbrookes Hospital?

I have managed to get refered to the Brighton one next month.

What are they doing to get your figures down?

All I know about the Oxford study is what is in the article I quoted. I can only suggest that you Google around with Professor Peter Rothwell's name for links.

Yes it is Addenbrookes.  More of the same really - Russian Roulette!  I've tried a range of medications since 1997.

this year I've changed from Adalat with Lisinopril to Candesartan and Adalat.  With the medication, my BPs are OK during the day but can be 150-160/100-110 in evenings and at night. 

I'm going to try Losartan and Adalat next week.

My most serious problem is the side effects: Hip, thigh muscle and knee pain/ache are extreme; wakes me at night.  Also, terrific cramp, e.g. in right foot.  Impotence.  Cannot distinguish between chest pains from heart or indigestion. Calcium supplement reduces indigestion pain, plus Bisodol; upward wind is excessive at bedtime. The Calcium supplement has led to tingling sensations, like ‘streaming pins and needles’ down my right arm.

Most of your symptoms are similar to mine apart from the time of day when our BP hits its heights. I ignore my chest pain as I have had it so long...Hiatus Hernia, Functional Indigestion etc. I was prescribed a PPI by a cardiologist in 2000 and have taken one ever since. Strange it did not prevent me from getting a duodenal ulcer. I often need to take some Gaviscon or Bisodol during the night.

Thigh pains stopped when i stopped taking Statins. Joint pains in hips, knees and feet/toes started when I was first prescribed Warfarin and went when I stopped it and reverted to aspirin. Now back on Warfarin after going into AF and joint  pains are back.

Orthopaedic consultant said that any drug can cause joint pain. 

Losartan has been the least troublesome of the ones I hve been on apart from an all over underskin itching feeling. That stopped when Losartan was replaced with other drugs for a while but is now back.

Over time I have had:

Atenolol, Amlodipine, Lisinipril, Securon (verapamil) Enalapril,Irbesartan, Ramipril, Perindopril as wel as Losartan and varios diruretics. All diruretics gave me pain in the pelvic area. The 'prils' gave me the worst side effects.

Adalat is a new one to me. I must look it up.

Thanks for your response.  Interesting that Losartan has given you the least problems; the Addenbrookes Dr said the same on Monday.  I'm not holding my breath though!

Adalat is a Nifedipine (a Calcium Chanel Blocker - like Amlodipine); I've been taking it for most of these 17 Years.  It only works for me if taken with an ACE inhibitor such as Lisinopril or an ARB such as Candesartan.  I used to hold Adalat responsible for most of my side effects but now I believe that it was the ACE inhibitor (Lisinopril), which also gave me couch and big chest congestion.  The ARB (Candesartan) is better in that respect, but I am hoping that Losartan might reduce the other side effects that I mentioned before.  I read this morning that 'Vitamin D 2000 iu' helps reduce muscle and bone ache?

I too have a small hiatus hernia, which I'm told is quite common, and so far my GP has ignored it.

Losartan got massive publicity in the press for its effectiveness in its early days. They also said that it helped with E.D.

Lisinopril gave me my worst reaction. It was started at 2.5mg, upped to 5mg and finally 10mg. That was when I became flushed, tingling lips, tongue and a blood blister thing came up on the back of my throat.

When I told a Jumior doctor that she was thrilled and said it was a classic reaction:-)

Enalapril brought me out in a rash.

Every different cardiologist I see wants to put me on Amlodipine. When I tell them that I pleaded to be taken off it they say that the side effects must have been caused by the Atenolol that I was taking at the same time. From memory, all over itch, cough, cold hands, feet and Willie and E.D. Felt tired every evening around 7PM but could not sleep or had disturbed sleep. It was stopped after two months.

As my heart rate is normally in the 40's I don't want anything to slow it down. I only got to see a cardiologist again three years ago as I was found to have aortic stenosis when I tried to get on the renal denervation trials at Imperial College where they said that my BP was not consistantly high enough. The professor there sggested Perindopril and wrote of it in such glowing terrms that my GP said that the practice had switched all of their patients to it. I stopped it after a month and went back to Loartan due to side effects.

I hoped that having my aortic valve replaced would help my BP but no such luck... I got AF instead. 

Whenever I had a treadmill test it gave what turned out to be false positives for narrowed/ blocked arteries. After an angiogram showed my arteries to be clear in 2001 the consultanrt said that this time he would sort out my BP once and for all at his outpatients clininc. His Junior who had been thrilled by my Lisinopril reaction forgot to put that in my discharge notes so it did not happen. 

Hi Derek,

I came across this site and noticed there were no posts in the last six months. Prior to that it looked like you had some success with BP meds. How is your bp now, and what meds are you taking?

I am 69 and have had high bp for about 25 years. I was on bp meds for a year to lower my bo for surgery three years ago, but went off after surgery. I take my bp once or twice a day and before Christmas it raised from a normal of 160/90 to 180/110. I went back on my med (Micardis HCT 40mg/12.5mg) for six weeks with no result. My GP switched me to Telmisartan 80mg. There is some improvement down to 170/100 but only if I seriously restrict my sodium to between 500 and 100mg a day. If I have a little ketchup or packaged food that brings me over 1500mg sodium per day I'kk go bak up to 185/105 or higher.

I'm going to ask my GP to test my aldosterone and cortisol blood levels. I have had small adrenal cysts on scans in the past. I've been to a cardiologist and a kidney doctor but they say my heart and kidneys are OK.

I also have a very weird blood levels of high monocytes, high hemoglobin and high red blood cells (all over the normal ranges) and low iron cespite taking ferrous sulfate for 4 months, but no one seems to know whay. My other white blood cells are good.

I don't have any notieceable symptoms, no swelling, shortness of breath etc. I walk and do 5 minutes on a steep incline treadmill equivalent to climbing 10 flights of stairs in 5 minutes. I'm wondering if I just have to live with it and wait for a stroke, or if something else will get me first? The state of diagnosis of hypertension seems pretty abysmal froom what I have seen so far.

P.S. Sorry for all the typos in my message above. I forgot to proof read before I submitted. Will just add two additional items to the discussion.

1. My bp is higher at night than in the morning. Usually 170/100 or less in the morning, and 185/105 or higher at night. If I take a second reading after resting my arm for a minute or two it generally lowers the reading by 10 points or so, top and bottom numbers. (I guess white coat syndrome is possible even at home).

2. After taking a hot shower after my evening reading my pressure will go down substantially. For example:

1st evening reading at 1:54AM ... 196/114

2nd evening reading at 1:57 AM ... 183/102

3rd evening reading after a hot shower. 3:03AM ...  158/84.

This is pretty typical of the after hot shower drop. Unfortunatrely i can't stay in the shower all day. Unfortunately nothing else has this bp lowering effect, not even the meds or lowering my sodium intake.

You could have B12 deficiency.  Look up Pernicious Anemia  -- ask if your red blood cells look weird.

I also have to tell you that that exercise equivalency is NOT the same.  Try running up ten flights of stairs in 5 minutes, and you'll see the difference right away.  I have had high blood pressure for almost 20 years now, and lately it has been a steady Super high of 206ish/ 106ish, but when I kind of push myself by doing something like pushing a heavy grocery cart around a store for half an hour, and then taking a twenty minute walk home, first on an incline, and then a steep hill, I feel like my head is going to shoot off of my body, but then my pressure does come down quite a bit for a few days, so you might want to do a kind of intense workout for a longer period of time -- ask your doctor.

Have had a very bizarre month in terms of BP. Just took it and it is 115/84.

I keep a journal of bp readings taken twice a day. Often take several readings when one is an oddball and record the one that seems most consistent.

To recap. I stopped taking Micardis HCT 40/12.5  (which had worked for me in the past) on 2/16/16 after taking it for 8 weeks because my bp stayed in the range of 170/98 to 195/109. My doctor switched me over to plain Micardis 80mg (no HCT) on that day. The reason I had stopped Micardis HCT more than a year earlier was because after yard work my BP would crash to as low as 85/45 and the room would seem to darken as I saw spots in front of my eyes, and felt like I was passing out. 

After 8 weeks of taking the Micardis 80mg, exercising, etc. I saw improvements in my bp to the range of 149/79 to 174/93. One of the exercises I was doing 3 times a week were isometric hand exercises I had seen in a medical study. It uses a hand dynomometer to measure you max grip in each hand, then do 4 sets in each hand of 30%  of max held for 2 minutes, 3 minutes rest. Total time is 20 minutes per hand or 40 minutes total. The only reason I mention it is because it may have had something to do with what came next.

On 3/19/16, my bp started to crash down to the 110/70 range and I discontinue the Micardis 80mg. (The only other drugs I take are dutasteride for prostate and iron pills for below normal iron). For the past 10 days my bp has been consistenly in the range of 117/80 to 134/ 84.

I'm waiting to see what happens next. I am slowly getting back into exercising, I have had a persistent hacking dry cough for a couple of weeks.

Just another note on the B12. I saw a couple of anecdotal posts on forums that B12 raised BP. Following surgeries last April my doctor put me on 2500 mcg per day. At the time my B12 was at the bottom of the normal range and my HGB and RBC hematocrit were below range due to 8 pints of blood transfusion needed before and after the surgeries. On my last blood tests in January, my B12 was in the middle of the normal range, but my HGB had gone to the top of the range at over 18 and my hematocrits were above the range. I started to apply logic and realized B12 increases blood volume. If you have high BP and blood volume increases, it should increases, your BP should go higher. At any rate I stopped taking the B12.

The thing that strikes me is that none of what happened to me is part of the standard medical protocol. And any patient outside of the standard protocols are as much of a mystery to doctors as they are to themselves. Like I said it's been a very bizarre experience. I'm 69 and retired and seem to have lost a great deal of energy ever since my surgeries. But I hope to keep slogging along.

I had the cough, and subsequent asthma, from Amlodipine and/or hydrchlorothiazide.  I never heard of B12 causing high blood pressure, but you can have high blood pressure if you are low.

Maybe if you just lower your dose of the Macardis you are taking now, everything will straighten out.  It could be your prostate or tge medicine you are taking for it.

If you haven't seen an endocrinologist, go see one.  It could be one of your glands that are responsible.

 

Cough is getting better, hack attacks mostly upon awakening, going to sleep, sporadic during the day but can go several hours at a time without coughing.

I think you are correct about the endocronologist. I had planned to ask my GP for a referral on my next visit. Very possible the thyroid, andrenal or pituitary gland can cause unexplained changes to BP.  I did have adrenal cysts on my scans a few years ago.

If my BP starts to rise up past 140 and 90 I will probably take the capsule every other day. Don't want to take something that I don't need, if my BP is less than 140/90. It's been in that range for 40 years and I only took BP meds a total of about a year during that time. I've been taking the dutasteride and the ferrous sulfate iron pills for about 5 months through all these changes so I don't think they are responsible.  Regarding the B12, I mostly don't want my HGB and hematocrits to keep rising. My HGB went from 8 to 18 in about 9 months. Seems like the B12 did it's job. I was just speculating the increase in blood volume might raise BP, but there's no medical studies that even mention it.

Have you had any luck with your BP? Maybe it's worth trying those hand isometrics I mentioned. A 1992 study  I read on the US Pubmed section of the cbi website said it lowered bp 9 points diastolic and systolic. You can find it and related studies by googling the study title....

Isometric exercise training lowers resting blood pressure.

I just started Propanolol last Saturday.  It has lowered my BP from 212/116 to 180/94 so far.  I am hyperthyroid, so my doctors think the HBP is because of that (I suspect it is also because of Adrenals or Pituitary as well). I have had a problem with any BP meds I gave tried, but decided to try the Propanolol because my BP was so high for over 2 weeks and never did come down.  I tried isometric excercises in 7th grade to increase my bust, maybe they will do a better job of lowering my BP.

Good luck with the Propanolol. Seems to be working quite well. It is not supposed to be used by people with asthma, just just be aware of that. Doesn't mean it won't work or will necessarily cause a problem. I have a fingertip pulse oxymeter that I use to check my pulse and oxygen twice a day when I monitor my bp. I figure if my oxygenation is usually above 95 my heart is working.

Honest drugs don't work people still have high bp try raw natural foods celery garlic ginger as tea green smoothies cayenne peppar etc change yor diet snd start yoga