High BP Not Responding To Meds

Posted , 10 users are following.

Hello all,

I am a 33 year old male, I do not smoke and never have, I don't drink alcohol unless its a special occasion, I eat quite healthy, workout 3 x per week with weights.

My blood pressure started spiking over the past 2 years, Feb 2014 I ws hitting levels of 170/125, I was flushing with headache, My GP surgery (I have seen various GPs there keep putting it down to stress/anxiety or essential hypertension) I did have 3, 24 hour urine tests, one of which came back with slight above range catecholamines, I think the adrenaline one, but I was then told to cut out certain foods/drink and redo the tests both of which came out normal after.

I am in need of an eye operation, however I failed pre-op as my blood pressure on the day was consistant 160/110, I have since been trying to get this down and have tried Ramipril 2.5mg - not enough 5g made me very fatigued and still didnt bring it down, propranolol 80mg sustained release (worked for a little time) propranolol 160mg sustained release ( hindered my exercise without making a massive difference to bp), currently on Ramipril 2.5mg alongside amlodopine 5mg for the past 2 days, bp readings from today are, 159/98 - 70bpm (irregular beat detected), 140/88 - 83 bpm, 144/89 - 85 bpm, 160/101 - 75 bpm, 143/101 - 79 bpm, 156/109 - 81 bpm.

I have asked for 24 hour bp monitoring and ecg monitoring but have been refused by my gp saying they dont do that anymore, not sure where to go with this, I will fail pre-op again and I also believe this is going to be secondary hypertension. any ideas?

I have had what I would call boarderline high BP for some years as in my baseline was around 140/90

1 like, 42 replies

42 Replies

  • Posted

    I realise that circumstances alter cases, but what you are describing is reminescent of my own circumstances when I was in my early thirties.

    If I remember my BP regularly topped-out at 200/150 and my doctor tried many different meds on me, and it only finally came down when a new Indian lady doctor completely changed my meds regime.

    At that time I was called-in to the surgery for BP checks every two or three days for what seemed like an eternity, but finally with the new meds it did gradually start to come down.

    Today I am in my 70's and my BP floats around 140/80 which I am told is still too high as I am now a diabetic.

    I think the main issue here is whether your surgery is taking a real and involved interest in your health.

    I do realise that things today are somewhat different, as all surgeries seem overcrowded and overworked, which I must say doesn't interest me one bit.

    If I feel that something needs to be done about my health and they are not doing it I simply pester the life out of them until they react the way that I want them to.

    If your surgery will not give you the regular checks that you have requested, if I were you I would consider purchasing your own decent quality sphygmomanometer and keep a regular graphic record of the BP readings taken at regular times.

    You could always produce this analysis as 'evidence' if you feel that the present meds are not working.

    It would also be helpful to you in ascertaining when the peaks and troughs occur during the day, which might give you a clue as to what exactly is going on.

  • Posted

    Stick with the amlodipine it takes a while but does work.  Try drinking beet root juice and go fir long walks.  I know you said you work out but walks in the fresh air seem to ease stress which is a great one for increasing bp
  • Posted

    I had similar situation, it sounds like stress, I ate healthy and excersised daily but it was stress and not relaxing, spent 2 years learning to relax and doing meditation, if your spikes in BP are stress related then no BP med will help anyway, amlodipine will definitely work but try not to stay on it long, if you research it you will see it is banned in most other countries and only used in veterinary practice!!!! I now do yoga which is fab and really does work at relaxing the mind, you will get there, good luck
  • Posted

    Hi Vigilante. Interesting post. Before I chuck my "sixpeneth" in, can I ask one thing? You work out you say. Do you or have you taken ANY stimulants/supplements to help you? If so what are they and how long have you taken them. I include energy drinks in this. Get back to me when you can.
    • Posted

      Thanks all for the replies, The only supplements I take are vitamins, CoQ10, Vit D3, B12, ALA, occasionaly I will use whey protein powders, I do eat a high satuated fat high protein caveman style diet and avoid gluten/sugars and most man made foods when possible.
  • Posted

    I am also splitting up when I take the meds, I do the Ramipril 2.5mg in the mornings and Amlodopine 5mg before bed? would that make a difference, should I take both together either mornings or evenings?

    Reading just after waking up this morning - 133/96

  • Posted

    Vigilante, I can't understand your GP saying that they don't do 24 hr BP monitoring any more!  If that is the case, I think I would change to another practice.  I'm sorry I'm unable to help as to which medication will work for you to get your blood pressure down as I am in a similar boat having tried six different meds to date.  Some do work on the BP but produce horrendous side effects for me.  Amlodipine is supposed to be one of the best at tackling blood pressure, providing you aren't someone who suffers the side effects - it is not, as one person has mentioned, "banned in most other countries".  

    As you are so young and not responding to different medications, I think your GP should at least refer you for investigation to rule out any problems with your kidney function, for instance, that may be keeping your BP high.

    I'm sorry I can't be more helpful than this - you need a different GP who is prepared to work with you not against you.  Good luck with both the BP and the eye op, and do let us know how you get on.

  • Posted

    I agree with Mrs.O.Any practice who says they don't do 24 hr monitoring any more needs the sack! Of course they do and if they don't then they should. You should insist.

    And saturated fat is good for you too although the dinosaurs at the NHS will tell you otherwise, butter tastes better than plastic margarine in any event.

    Does sound to me as though the GP isn't too interested in sorting this for you. I was lucky I guess with a good GP who listened. Initially another GP had implied it was hereditary and "I wouldn't be able to sort it on my own". This attitude of his made me all the more determined to try. Didn't actually work but all the same I only take the lowest dose of Losartan. Ramipril gave me a cough.

    a 24 hr monitor diagnosed me at 163/96 [stage 2] and now have an average of between 120 and 130 systolic and 75-80 diastolic. I'm 70 btw. This was after one of the NHS health checks.

  • Posted

    Hi. Doesn't seem to be anything too disastrous in your diet. Opinion on saturated fats is changing. They are considered good. I agree that butter is better than plastic margarine. But I think you should be pushing your GP for help as you are due an eye operation and the surgeon won't be happy if you need an op but are failing pre op procedures due to high bp.

    Get another appointment with your GP and push the eye surgery thing and/or see a different GP at your practise.

    Sadly in this day and age its those who shout loudest who get the attention!!

    Keep us posted.....good luck

  • Posted

    Hey all thanks for the replies, I managed to have a chat to my gp, who has now taken me off the ramipril as he thinks im unsuited to that as I get irregular heart beats show up on my monitor and increasing dose of it fatigues me badly, he wants to stop the calcium channel blocker for now too and try me on Losartan 50mg?
    • Posted

      good luck with the Losartan, I'm sure you'll be fine on it, not many side effects that you hear about.Certainly I've not had any.
    • Posted

      Vigilante,  after trying 6 different BP pills, Losartan 50mg is, so far, the only one that hasn't produced any discernible side effects for me.  Unfortunately, for some reason it isn't doing a thing for my blood pressure so, no doubt at my next renal appointment yet another drug will be introduced.  My pharmacist has told me that Losartan is the drug about which he hears the least complaints from patients, so looking very promising for you.  Good luck and do keep in touch and let us know how you get on. 
    • Posted

      Thank you all, I will keep you updated. My GP did say that Losartan was much better for side effects, he didnt say how long it might take to see any effect on readings though?
    • Posted

      It can probably vary from person to person, but they usually say it can take 2-3 weeks for any new pill to take full effect.
  • Posted

    Interestingly I've just been reading in the Daily Mail that Ace inhibitors and beta blockers REDUCE blood pressure and calcium channel blockers STABILISE it. Losartan isn't either though, it's an angiotensin receptor blocker - not entirely the same thing I don't think.

    The point being that it's wild fluctuations in BP that causes problems, strokdes specifically they mentioned.

    • Posted

      Articles always say that but all doctors and specialists I've seen deny it just as they tell me that it is my average BP that matters not the high and lows.
    • Posted

      On any one day it can be morning 210/93 evening 109/64 = average 159/78. That is too extreme for my system  to cope with and causes pre cyncope

      Most months on three readings a day my average is 156/71 

    • Posted

      It is too high then.

      I've been on Losartan for years and I find it ok, but they may have 'experiment' with you (as they did at one time with me) to get the cocktail just right.

      The most important factor is for your doctor to attend to it.

    • Posted

      I was on many meds around 2000/2001 since then Losartan.

      I have been attending a Hypertension Centre at a hospital

      since last June. Many tests performed and nothing found to cause my labile hypertension and no change to med apart from suggestion to reduce Losartan from 100mg to 50mg.  

    • Posted

      A doctor comment at my last two GP surgeries. We don't really treat BP here if we did we would not have time to see any other patients.

      There is no money in it for them.


    • Posted

      That is an outrageous attitude to take, and if it was me, I would report them to the GMC.

      I wonder what those two surgeries would say if as a result of NOT treating BP a patient suffered a stroke?

    • Posted

      They probably do suffer strokes.

      Some years ago after having a clear angiogram after a second false positive stress test the consultant said that this time he would finally sort out my BP at his out patients clinic.When I heard nothing I spoke to my then GP who said that it had not been put in my discharge notes.

      I phoned the consultants secretary and got the same response. When I asked my GP to refer me he said if everyone with similar hypertension was referred to the hypertension clinic there would be a queue all the way from his and every surgery.  


    • Posted

      I bet if those consultants and GP's suffered with uncontrollable hypertension they would find one way or another to get to the top of the queue.

      This is precisely why if I have a medical problem and my GP/ surgery try to fob me off I give them a rude awakening, and have been known to threaten them with a formal complaint.

      It is very strange how it always seems to motivate them into action - I wonder why?

    • Posted

      Is it uncontrolable or labile?  It has varied like this since 2000 without incident.

      Now after four consultations at my instigation  with a senior consultant in renal medicine at a European Society of Hypertension Centre of Excellence it is questioned if i am really hyppertensive or have labile hypertension with peaks. Quoting this consultant on cardiologists:

      "They are very clever people and do very intricate things that I cannot do but they do not understand hypertension. For that you need an expert like me" 

      Part of what he then wrote to my GP:

      “ His blood pressure at the clinic today was 187/82. He has very labile hypertension but I wonder the reality if it is his blood pressure tends to be low but very reactive rather than predominately high certainly he seems to have had side effects on a number of antihypertensives raising the question as to whether he was in fact being over treated. To avoid complicating things we are leaving his medication as it is although if he gets symptomatic hypertension it would probably be worth reducing his losartan (from 100mg to 50mg).

      We will arrange the MR scan and I look forward to hearing the results of his 24 hour ambulatory monitor. 

      Going into his past in a little more detail it sounds as if he hasn’t had a lot in the way of investigations for his hypertension and I am going to arrange an MR scan to address his aneurysm but more importantly whether his renal arteries are involved in it (which might not be apparent from the surveillance ultrasounds he gets) and also to clarify a little more about his liver cysts and in particular the extent to which his kidneys may be involved”

      Nothing of note from the MR scan apart from a slight narrowing of one renal artery. In view of my recent hospital visit with very high BP and AF that initially settled but after a week dropped to extreme BP lows and irregular heart rate I am going to contact him to try to get my July appointment brought forward while waiting a for 7 day ECG and cardiology appointment at my local hospital.   


    • Posted

      He has got a point, it could be either, but they do seem to be taking it seriously but according to you doing nothing about it - is that correct?

      I didn't realise that you had an aneurysm and there might be a question of narrowing of the renal arteries.

      I see the relevent question as being is it circumstantial or clinical?

      My bet from his initial report is that it is clinical.

      So exactly where are you at now with the problem?

    • Posted

      The aortic aneurysm is quite small at 3.6 cm. (3.1 when first detected around 2004) The renal artery narrowing is minimal. Last time at the end of the consultation I mentioned that at the first consultation that he had said that there are families of medications that I have not yet tried. I asked if he wanted to change from Losartan and he said no. I suggested that we were not getting anywhere and asked if he wanted to see me again. He did, in six months as all the appointments have been.  He has one half day hypertension clinic a week so he cannot see many people or very often. In January he had a CT1 doing the early part of the consultation before he joined in.  
    • Posted

      Derek, I am at risk of aortic aneurism due to having suffered an autoimmune illness that comes under the umbrella of vasculitis, and it has been recommended that I am checked every two years via a chest X-ray. Although this X-ray should have been carried out during my years on treatment, it was missed, and, so far, since beng in remission I have had one such chest X-ra, thankfully with a clear result.  I am interested to know if your aneurism is checked by regular X-rays or by MRIs?  The very small growth of your aneurism over 10+ years is looking very promising, hopefully ruling out surgery at any time in the future.
    • Posted

      I would not be very happy with that performance, or lack of it as the case may be.

      Would you consider going back to your GP and asking for a second opinion from an alternative specialist?

    • Posted

      This is an abdominal aortic aneurism not up nearer the heart as yours must be if they do chest x-Rays. I have an ultrasound scan every year.

      They always welcome me with 'Here is the man with the small one' It was noticed by chance when I had my gall bladder scanned, 

      Told then that Gal Bladder OK but small aneurism and a lot of harmless cysts on my liver. Later another harmless cyst on a kidney and last year two more.

    • Posted

      This Guy is supposed to be the best. From the cardiology point of view I have seen plenty including a professor at Imperial College in 2011 when I tried to get on the renal denervation programme and told that my BP was not consistently high enough. Very thorough examination and tests where he fortunately found that I had aortic stenosis and later I had valve replacement. I have been well looked at but no answer to my BP.  

      I tried again for renal denervation when my local hospital  doing trials on it in 2013 and again told not consistently high enough.

      I don't understand why I get excessive highs first thing in the morning and lows by afternoon.

      I had my BP checked in November 1999 when having a prostate biopsy and it was in the 140's. In February 2000 I went to my GP with 'indigestion' and it was suddenly 210/110 and I was sent to the Chest Pain Clinic for ECG, Echo cardiogram and stress ECG. False positive from the stress test as with one I had in 1993 and others since.

      I've got to 80 and it aint killed me yet .  

    • Posted

      Goodness gracious, you are old enough to be my dad (that is if you started early enough) - I'm 71.

      I can understand your concern, as I would have the same things bothering me.

      So basically unless you are ready willing and able to give up the ghost I think you need to get some answers from these so-called professionals.

    • Posted

      Oh dear Derek you have had more than your fair share of cysts by the sound of it.  Some years ago, I was told during an ultrasound scan that I had a gallstone;  however, when I asked about it at a recent scan, I was told ther was no sign of it now.

      Only "aortic aneurism" has been mentioned, with no mention of "abdominal" in my case.  At least if the ultrasound scan you are having is sufficient, then you aren't running the risk of the contrasts used in the MRIs.

      The "welcome" they give you made me chuckle!lol

    • Posted

      I was a very precocious boy but not enough to be your Dad. Actually at 9 I was in hospital with Perhes Disease and would not have been able to get my leg over:-)

      I'm just as pushy as you and have fought the NHS on all fronts and won but this one is a mystery and defeats all of them.  

      I sometimes vainly ask them, Is it just me? They all start off full of confidence and good intentions.


    • Posted

      Long may it be a tiddler as it is a serious operation. I was speaking to a man on a bus from the hospital one day and he had his repaired in his 80's.

      Someone who would not sell me travel insurance at Saga said that her Gran had the operation in her 90's. 

      One doing the scan said it would not cost the insurance company much if it burst when I was on holiday............ just the ambulance to take me to the mortuary:-)

      Once when we were thinking of buying in Brighton we looked at a flat minutes from the Royal  Sussex. I thought that it might prove handy  one day. A friend who was a policeman told me that burst aneurysms are the top cause of death for middle aged men found dead at home. There is now a national screening programme for men over 65.

    • Posted

      The screening programme is not before time, Derek.  However, I have heard that finding them when they're very small can cause unnecessary worry for years, but that it is important to avoid intervention until absolutely necessary.
    • Posted

      When it is first diagnosed you assume that it is going to grow but in time you realise that they are mostly slow growing and watchful waiting is enough. My prostate grows much more quickly and have twice had it lasered in that time.

      I did ask what can be done to reduce the risk and was told controlling blood pressure and taking statins. Neither much good for me!


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