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Developed HBP. Not Controlled By Medicine. What Should Be Done?

Posted on Tue, 12 Mar 2013

Question: i am a 39 year old female who has been unwell for several months and have recently developed high blood pressure which is not responding well to medication. My medication was recently changed to a beta blocker and my resting heart rate has dropped considerably - it is currently 44BPM should i be concerned?

Answered by Dr. Gopal Krishna Dash (15 minutes later)

Hello,
Thanks for the query.

Usually essential hypertension (the high BP that does not have any other cause) responds to treatment. If a patient does not respond to medicines, then one has to check the entire medicine list (I don't know what medicines that you on apart from beta blocker) and any other secondary cause which can make someone no-responsive to medicines. These secondary causes are thyroid problem, adrenal gland problem, high salt intake, use of concurrent other medicines that can nullify the effect of antihypertensive drugs, presence of kidney problem and so on.
Beta blocker can slow down the heart rate. If you have symptoms related to low heart rate like dizziness etc, you may opt for other medicines too. You need not worry at all in relation to the heart rate as it mostly related to beta blocker and it will improve after changing over to another anti-hypertensive drug

Basically you need evaluation to find out the cause of refractory hypertension.
So get evaluated and don't worry
Hope this clarifies
I will be happy to address your query in this issue again

Best wishes

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Gopal Krishna Dash (45 hours later)

thanks for that - it has eased my mind a little - the only other medication i am taking is 25mg of Endep once at night - my thyroid has been tested and is fine - my kidney function has been tested and it is fine - i am currently having my cortisol and aldosterone levels rechecked as the cortisol shows high plasma cortisol but normal urinary cortisol levels and high urinary aldosterone levels but normal plasma aldosterone - I believe both plasma & urinary results should be either normal or abnormal - is this your understanding? Do you know of any other situations that can cause my sudden onset of high blood pressure?
thanks XXXXXXX

Answered by Dr. Gopal Krishna Dash (2 hours later)

Hello,

Thanks for the feed back

I agree with you that in most of the situations, both the plasma and urinary levels are high in patients with hyper functioning adrenal glands. The other important situation that can cause sudden high blood pressure is pheochromocytoma, a tumor of the adrenal gland.

Please consult a local endocrinologist and get your tests done.

if a cause is found, proper management will result in normalization of your blood pressure

I hope this helps.
In case you have any further questions, please feel free and get back to me

Best wishes

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli