Review the best ways to control resistant hypertension
BY DR. KOMOROFF Universal Uclick
Thursday, December 13, 2012
12/13/12 at 3:58 AM
Dear Doctor K: I've made lifestyle changes and take three blood pressure medications, but my blood pressure still isn't where my doctor wants it to be. What else can I do?
Dear Reader: Sometimes high blood pressure (hypertension) doesn't respond to lifestyle changes and medications. This is called resistant hypertension.
And controlling this matters. Heart disease, for example, is much more common in people with resistant hypertension than in people with controlled blood pressure.
Some steps you can take:
Know your true blood pressure. Check your blood pressure at home a few times a day. Home blood pressure machines are very accurate these days.
Optimize your medications. You're probably already taking a thiazide diuretic. Many types of drugs can be added to the diuretic. The time of day you take your medications may make a difference; so might taking one long-acting drug versus several short-acting medications.
Beware other pills and potions. Some drugs and supplements can boost blood pressure. Ask your doctor if anything you are taking may be having this effect.
Get a checkup. In particular, get checked for conditions that contribute to resistant hypertension, such as several adrenal gland diseases, silent kidney disease and sleep apnea.
Shake the salt habit. Keep your daily intake of sodium under 1,500 milligrams (about 2/3 teaspoon of salt).
Stick with the standards: exercise, weight control, eating more fruits and vegetables, no smoking, alcohol in moderation, if at all and stress-relieving activities.
A personal anecdote: I have mild high blood pressure that has been easily controlled with medicines for many years. Several months ago, my blood pressure started to go up. The only thing that was different was I had gained about 4 pounds on vacation. When I lost 8 pounds over the next three weeks, my blood pressure dropped to normal.
Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106