Resistant Hypertension

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Since being diagnosed with very high blood pressure (bp) in 1999, I've had a difficult time finding a bp medication that doesn't give me intolerable side effects and/or lowers the bp to an acceptable level.   I have been on all the different classes of bp meds and have been on Carvedilol, a beta blocker (25 twice daily) since 2011.  However, in the last few months my upper bp number has been in the high 150's to low 160's.  Although on the highest recommended dose, my doctor had me try 25 three times daily which resulted in intolerable side effects.  Then tried 2 1/2 daily (although the pill should not be split) but it still didn't lower bp enough.  Also, since being on Carvedilol I've noticed considerable hair thinning, low platelet count, double vision in one eye, worse tinnitus, joint pain, and crusty scalp.  My doctor didn't think these symptoms are from Carvedilol and was attributing them to aging (I'm in my 60's).  I told her I thought it awfully coincidental that all these symptoms have developed while being on Carvedilol and want to get off a beta blocker.  I've also become a blood "clumper" in the last two years but the hematologist doesn't think it's from the beta blocker (?).  She is not happy with me since we've tried so many other bp meds (Carvedilol is the 12th) but I finally convinced her to get me off it.  I am currently weaning off Carvedilol and she had me add one low dose Amlodipine Besylate (a calcium channel blocker) while doing so.  But I've tried a calcium channel blocker in the past and got leg, foot, ankle, and shoulder flu like aches.  Well, we will see how this works.  My doctor is practically at a loss for what else to do and may refer me to a cardiologist.   ALL that being said, is anyone else having a difficult time finding a bp medication that lowers it enough without intolerable side effects?

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  • Posted

    If you are in the UK ask to be referred to a "hypertension referral centre" They are more expert at BP than cardiologists. Google the words and you will find one in your area. They tend to have a long waiting time but are very thorough and will do a lot of tests.

    • Posted

      Thank you for your response, I am in Illinois, USA.
    • Posted

      They must have similar facilities there.

      When we were in Chicago we visited Cook County Hospital where ER scences were filmed. A doctor spoke to us gave us a tour though not much was really filmed there but in the Hollywood studios.

  • Posted

    Lynn, that could have been me writing your post.  Added to which my high BP is further damaging my sole kidney function.  Both my GP and my renal consultant are also "at a loss for what else to do", with my GP telling me that she hasn't got anyone else like me.  I feel like printing off your post just to show her that I'm not the only "awkward patient" in the universe!  Because of my experience, I'm sorry that I haven't got any answers for you but just wanted to let you know you are certainly not alone - they do say that misery loves company!  All the very best to you, Lynn.

    • Posted

      Thank you.  Yes, my doctor thinks I'm "difficult" when I tell her about all the different side effects from all the different bp meds we have tried.  I tell her I've been in this body for 60+ years and I surely know when something isn't right!  I am going to search for a hypertension specialist as derek76 suggested.  Best to you also.

  • Posted

    I did in the past I had terrible side effects with Metropolo.l I have been successful on 20 milligrams of Lisinopril twice a day and 25 milligrams of Atenolol twice a day I also take Ranexa 1000 twice today and isosorbide 60 milligrams a day. they are for angina. Your side effects don't sound like BP side effects but then I'm not a doctor. You might need some vitamins and magnesium supplements they help me a lot. Your top number on BP isn't that drastic mine spikes to in the 190s and I have seizure-like effects from it I usually can get it down with extra meds. You have to be careful mixing beta blockers with anything else usually only with the ones that end in pril I'm not sure if it's an Ace inhibitor or what anyway I hope this helps you. keep plugging away at relief. You will be okay just give it a little time. Your age does have a lot to do with things like you mentioned. vitamin E and fish oil should help. regards with this Diana

    • Posted

      Thank you Diana. Without bp meds, my pressure was 211/126 (yikes!).  I do take vitamins, supplements, and herbs--I checked and all are safe and do not interact.  As you suggest, perhaps I need to be on more than one type of bp med.  But I've gotten so many side effects from all the different classes that it's been difficult to be on one let alone two or three more.  Still working on a solution!

    • Posted

      LynnG, Been there often over the past 16 years.
    • Posted

      Your BP was very super high. I've had it high but got a terrible reaction I lose my hearing aho Am confused and have seizures until it goes down to at least 160 over 85 then I feel better. there's nothing that can be done about it they say I just need electrolytes and some of it might be panic attacks but it all affects blood pressure. I never realized how high yours was. it's better now at what you have it at. you will be okay maybe another blood pressure med will do. it's better to have the side effects then to have a stroke are the seizures like I have irs horrible.

    • Posted

      diana , i  have had a terrible time trying to take BP tablets ! horriffic side effects , recently i had an episode where i felt breathless and all my muscles shook ,,, i ended up in hospital where i had an angio , it was ok they tell me or at least i do not need stents etc ,, they said it was my BP and put me on Isosorbide which was brilliant for my bp but gave me bleeding gums so i had to come off it ! since then my dr just says i have to persevere with small bits of candersartan which i find hard to take ! I see you say you put up with the side effects ,,,  how do you manage ? sorry to bother you but im so fed up now
    • Posted

      Hi Gwen Just wanted to say I feel for you - I've resisted medication for a time (years :-( ) I'd been on it and off it with little understanding from various GP's.

      I've to get the 24 hour monitor in a couple of weeks and am dreading it.  Clinic reading was really high, worryingly so.  Regular readings a number of years ago saw that they jump all over the place.  It's a horrible place to be ... personally I'm trying to keep calm and am working on losing that one and a half stone that's crept up on me ... just writing to say I'm thinking of you.  

    • Posted

      Thank you Wren , i get so depressed with all this because i never feel well , the Drs are not understanding at all ,, I could do with losing a bit of wt as well but its hard as im not as active as i once was ! I had a 24hr monitor and it was too high all the time ! Iv been told to take small bits of candesartan but its as bad ! you are good to resist tablets ,, i wish i could do without ! as for being calm that for me is so difficult ! it helps to know that  someone is thinking of me ! I said to the Dr i read on here about people having problems with tablets and she said perhaps i should not read ! why dont they ? I was a nurse and worked with nice Drs , i now find that the ones in GP practice leave a lot to be desired if you become a difficult patient ! take care and thanks x
  • Posted

    Hi LynnG,  I might be that person.  

    I was 55 years old when my high blood pressure was "diagnosed".  I am 60 now. Inbetween those years I had my hip replaced.  I was told that although my PB was high the anesthesiologist felt it was low enough to control during the operation.  I am now ready for my other hip to be replaced.  

    Everything was scheduled and ready to go.  Before the operation took place I went in for blood work and a blood pressure test.  BP is too high.  They won't do it until I bring it down. 

    My BP ranges from 174/100 to 185/125.   I have been on several meds and ALL have given me side effects, some overly annoying and some frightfully scary.  Just awful.  I honestly don't have on hand all the meds that I've taken but they fall into the various varieties of BP meds.  

    3 days ago my doctor told me there was no more medication he could offer me to treat my high blood pressure.  He's sending me to a cardiologist.

    I am very worried about being put onto some other crappy meds.  I'm not liking being a test rabbit.   

    I hope it goes well for you.  I will be looking for you to see how things turn out.  Good luck.

    • Posted

      What limit do they put on BP prior to hip surgery? BP usually goes down when you are under and there are drugs that the anesthetist can use.

      Google 'renal denervation' it could reduce your BP a bit.

    • Posted

      Thanks for your comment.  VERY good question.  I don't know.  Honestly I have thought of the question but have never asked it.  I suppose I am just so overwhelmed with everything I forget to ask.    

      As I said the anesthetist had no problems reducing my blood pressure during my first operation.  

      This time hospital took my blood pressure with a digital machine, the best out of the 3.   My doctor prefers to use the old fashined manual pump that was used the first time I had my hip replaced  While my doctor prefers the hand pump he is required to give the results from the digital.  My BP is always lower when he uses the hand pump-still high but lower.  I live in danmark, I don't know if that is the case where you are.

      Interestingly enough danish doctors don't automatically check for high blood pressure.  I mean to say that when I lived in the states every time I would see a doctor, old or new, the first thing they would do is take my blood pressure.  My BP has gone unnoticed for about 24 years. 

      I have looked into renal denervation and it does sound interesting and I hope it could be a possibility or something to at least talk about.  I live in Denmark so I'm not sure where they are on that.  Hopefully I'll learn more from the cardio dr.

      Thanks again derek76wink

    • Posted

      I tried to get on the renal denervation trial at Imperial College in 2011 but they said that my BP was not consistently high enough. At least the examination found my aortic stenosis and I had the valve replaced. The present renal denervation procedure is now in the third version.

      Not sure how widespread it is being used but my cardiologist is doing it now at a private clinic in Sussex but I don't know if he is doing it at the NHS hospital.

      When I had an operation in 2004 the anesthetist was concerned at my ECG but not my BP and wanted an Echocardiogram without having taken Losartan that day before he would proceed.

      When I saw a consultant about my hip he said that I did not need a replacement yet but he would be dubious about doing it due to my artificial heart valve.

    • Posted

      My hip man (that's just my name for my orthopedic surgeon) and I have no doubt that I would greatly benefit from the 2nd hip surgery.  I have 0 cartiledge in my hip joints and needless to say it is uncomfortable.  So I am a bit anxious about this BP problem.  I was fired from my job because I was unable to do the work.  Having had one new hip I feel 98% better. Things will never be the same.  Silly question maybe but how do you feel with the 3rd renal denervation?  I could wrap my head around the hip replacement.  I wasn't afraid of having it done but for some reason the renal drv. makes me nervous.  Since they don't think you need a new hip are you able to work?  If you don't mind me asking how old are you?  I am 60 from sept. 2016.  I have been off from work since November 1st.  

    • Posted

      As I said I did not qualify for renal denervation. The first version was the one I tried to get on the trial for. After a while it was not living up to expectations and was stopped for more research. They then went to version two and now are on the third generation one.

      The mother of my contact at the makers Medtronic had it and was satisfied with her improvment as were two others I have heard of,

      There is another treatment called the Rox Coupler where a clip is inserted into your groin to divert some bllod from the heart and reduce BP. It has the advantage of being removable if it does not help the patient.

       

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