What causes increase in blood pressure inspite of changing medications?
Patient: Hi, my husbands blood pressure has been on average 178/110 with some as high as 190/130. this has been going on for aprox 2 months. On Nov.2 his Dr. put him in hosp. for a week, changed his meds then let him go, he saw her a week later with no change. She then put him on Diovan 160mg, saw him 2 weeks later with no significant results. Last Fri. she doubled the dose of Diovan and wanted to see him tomorrow, now she is sick and can't see him til next week. His bp has not really gone down much and just now it is left arm 171/109, right arm 174/111. We live in a small town and not too sure about the level of care. Should he go to the hopital? Doctor: Hello!Welcome and thank you for asking on HcM!I passed carefully through your question and would explain that his blood pressure values are still high. This means that Diovan is not effective in controlling his blood pressure values. For this reason, I recommend consulting with another doctor and discussing the possibility of adding new anti-hypertensive drugs to his therapy (a diuretic like hydrochlorothyazide or a calcium channel blocker). It is also necessary performing some tests to investigate for the possible causes underlying his uncontrolled high blood pressure: - a chest X ray study- a resting ECG and cardiac ultrasound- complete blood count for anemia- fasting glucose for diabetes- thyroid hormone levels for thyroid dysfunction- cortisol and aldosterone plasma levels for adrenal gland dysfunction- blood electrolytes for possible imbalance- kidney and liver function tests. You should discuss with his doctor on the above issues. Kind regards, Dr. Iliri