Blood Pressure not responding

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Hi I have been taking 2.5mg Ramipril for the last 4 years with no problems (slight cough but not constant) When for review and

GO said doe needed to increase to 5mg as not controlling blood pressure. This was january. Within 10 days severe constant cough developed and go changed to Adalat LA 30. Unfortunately - 2 weeks later, it was not controlling bp so gp added 25mg Losartan. This did the trick but then developed badly swollen ankles and calves. GP said that this was Adalat so stopped that and increased Losartan to 50mg. That was 5 days ago but these are not controlling bp. Currently 169/89 resting. Any suggestions please?

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13 Replies

  • Posted

    It is really up to your GP to find a medication that works on your BP and does not have bad side effects. It is really hard to recommend something, because what works for some people doesn't for others.

    For example, I have seen complaints about amlopidine, which I have taken for 18 months without problems, but now I am starting to see the symptoms that others are describing, so it will be back to the GP next week for me.

    Are your BP readings at the surgery or are they monitored at home?

     

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    • Posted

      Hi RHGB, most readings are at home but these are supported when visit GP. I have appt with doctor on Monday to review Losartan. As you say, I guess just have to find something that works. Thanks
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  • Posted

    Your cough with Ramipril is typical of the drug, i had the same problem when the dose was increased so was immediately switched to Losartan which is fine [for me].

    I refused Amlodipine which the dr would have preferred as I like to eat grapefruit and you can't when you take any of the calcium channel blockers which I understand Adalat is. I'd never heard of that drug so I looked it up and it is a calcium channel blocker.  I have always heard that the side effects of ccb's are swelling of the  ankles and other rather unpleasant things.  You don't state how old you are as ccb s are the first drug usually offered if you are over 55 years.

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    • Posted

      Hi Jane

      I was ok on Ramipril until they increased the dose so had to change. I am 57 and generally (excluding blood pressure) in good health. However since the worsened cough as a result of the increased Ramipril, have not felt great. Still have mild cough (getting better) but it says on these forums that it can take some time for a ramipril cough to go once meds stopped. I am beginning to understand the bp meds are a bit 'hit and miss' and you just have to find what works for you. Unfortunately it's not a pleasant process. Thanks for your response.

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    • Posted

      Thanks, you learn about new things everyday, but not from the GP or the hospital.

      I had eight different medications when I came out of hospital (two month stay) 18 months ago, not once did I ever have any of them explained to me. I had to find out myself, and still I'm learning.

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    • Posted

      Hi RHGB

      Sounds like you have had a tough time. The problem seems to be that while the doctors are trying to find the right medication, you don't feel great or your blood pressure is uncontrolled.? It seems like trial and error.

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    • Posted

      I had to laugh, I went into the surgery in early January for something completely different and they had a questionnaire. I will just say, that I failed to mention that I am still taking all the medications (plus one prescribed but that is not from the GP) and they tried to put me on statins and aspirin just over 6 months ago. Anyway, back to the survey, it had two relevant questions out of about four.

      Do you understand what the medications that are being prescribed for you are for? Answer, no, nobody has ever told me.

      Have the medications ever caused you issues? Yes, the amount must have caused a chemical imbalance, because for months I was fatigued and irritable when I'd taken them.

      I thought that might lead to them being explained to me, but nope. And I consider that I have a decent GP surgery, I could phone tomorrow morning and get an appointment tomorrow, as long as I didn't stipulate which doctor.

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    • Posted

      Since I was found to have hypertension 3 years ago ,and I'm 73 btw I have found that the drs would probably prefer you not to look at the internet for guidance on the different medications available as they see you as a threat to their authority. "Do as I say and not as I do" is often the order of the day! Just my opinion. And the more I read and the more I discover the more I realise the drs themselves are just reading from a script and ticking boxes. They have so much paperwork and red tape to contend with they no longer have the time to really talk to patients.

       I have had a wonderful dr for the past 3 years who is not like that at all only unfortunately she is leaving the practice so I have to choose another. It won't be easy!

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    • Posted

      Very true. The things is, we could spend an evening a week, on just one ailment and medication until we became 'experts' in that small field. Because that particular problem affects us, and we are willing to devote an awful lot of time to it. Whereas a GP will spread their resources thinly, follow one size fits all guidelines and some of that seems to be written by the pharmaceutical companies.

      Good luck with your doctor hunt, they are few and far between these days. I've given my parents address before for many years, just so I could hang on to a doctor, even though I lived a distance  away.

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  • Posted

    How do you know if you've got bp mine goes high all my life at doctors I became phobic with my own monitor too. I gave up and told doctors to leave me alone. I'll live untill I die there no way I can get an accurate reading.
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    • Posted

      Well, what ever works for you. I never kept up with my BP tablets.

      And nearly two years ago I had a bleed on the brain stroke (ICH), an artery burst and the main cause was unchecked hypertension. I spent two months in hospital, lost the use of my legs and partly my right arm whilst in hospital - spent the time in a wheelchair.

      I had nine months of physio as an outpateint at the stroke hospital, and I had my last appointments with the psychiatrist, speech therapist and neuro surgeon consultant just before Christmas.

      I was 48 when I had it, not exactly old. I didn't think anything would happen to me either. I'm one of the lucky ones, that kind of stroke has a close on 50% mortality rate.

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  • Posted

    pammied,

    Losartan works very well with thiazide like diuretics.

    ARB (Losartan) + thiazide like diuretic (HCTZ, Indapamide, Chlotalidone) is one of the combos recommended by the American Hypertension Society.

    http://www.ashjournal.com/article/S1933-1711(10)00006-9/fulltext#sec7

    Unmedicated I was 170/110. 100 MG of losartan I was 160/100. With Losartan + 12.5 mg of HCTZ I was 120/75. 

    Good Luck!

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    • Posted

      Thanks Dave. I will bear that in mind.

      I went to see my go on Monday as the 50mg Losartan was not solving the bp issue.

      Despite readings recently of 175/90 whilst on the Losartan, GO says he is more interested in averages. These have been running at about 145/80 courtesy of some lower overnight/early readings.

      I said I was not happy as I would like to avoid a stroke if at all possible. He agreed to increase the dose to 75mg (to be taken at night to avoid woolly handedness during the day).

      Been doing this since Monday and pressures seem better already. He wants to review in a couple of weeks.

      I was however interested in something I saw earlier on this site about magnesium possibly helping?

      Thanks for the suggestion

      Pammied

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