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Suggest Treatment For Uncontrolled Hypertension Despite Taking Medication

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Posted on Sat, 2 Jun 2018
Question: what should I do when my blood pressure is reaching as high as 200--I am on 25 mgs of Losartan Potassium a day!
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Answered by Dr. Ilir Sharka (30 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would explain that such high blood pressure values are quite high and dangerous; they may lead to serious complications such as hemorrhagic stroke, pulmonary edema, eye (retina) damage, kidney dysfunction, etc.

Considering your uncontrolled hypertension due to persistently very high BP values, your current therapy seems insufficient.

Losartan dosage (25 mg/day) is pretty low and should be increased up to 100 mg/day and it is necessary switching to multi drug therapy (two or more anti-hypertensive medications). A calcium channel blocker (Amlodipine, Lecarnidipine, etc.), a diuretic (Hydrochlorothiazide, etc), a beta-blocker (Carvedilol, Bisoprolol, Metoprolol, etc) could be alternatives in this regard.

Meanwhile, I recommend performing additional medical tests for investigating possible triggering factors of your persistent hypertension:

- complete blood count (possible anemia),
- thyroid hormones level (possible thyroid dysfunction),
- blood electrolytes level, urinary metanephrine, aldosterone and cortisol levels (for adrenal dysfunction),
- plasma renin activity,
- kidney and liver function tests,
- fasting blood glucose,
- arterial blood gas analysis

I recommend checking closely your blood pressure values for a couple of day (several times daily) and discussing with your attending doctor on the above mentioned issues.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9542 Questions

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Suggest Treatment For Uncontrolled Hypertension Despite Taking Medication

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on HCM! Regarding your concern, I would explain that such high blood pressure values are quite high and dangerous; they may lead to serious complications such as hemorrhagic stroke, pulmonary edema, eye (retina) damage, kidney dysfunction, etc. Considering your uncontrolled hypertension due to persistently very high BP values, your current therapy seems insufficient. Losartan dosage (25 mg/day) is pretty low and should be increased up to 100 mg/day and it is necessary switching to multi drug therapy (two or more anti-hypertensive medications). A calcium channel blocker (Amlodipine, Lecarnidipine, etc.), a diuretic (Hydrochlorothiazide, etc), a beta-blocker (Carvedilol, Bisoprolol, Metoprolol, etc) could be alternatives in this regard. Meanwhile, I recommend performing additional medical tests for investigating possible triggering factors of your persistent hypertension: - complete blood count (possible anemia), - thyroid hormones level (possible thyroid dysfunction), - blood electrolytes level, urinary metanephrine, aldosterone and cortisol levels (for adrenal dysfunction), - plasma renin activity, - kidney and liver function tests, - fasting blood glucose, - arterial blood gas analysis I recommend checking closely your blood pressure values for a couple of day (several times daily) and discussing with your attending doctor on the above mentioned issues. Hope to have been helpful to you! In case of any further questions, feel free to ask me again. Kind regards, Dr. Iliri