What Causes Persistent Hypertension Despite Taking Medication?

Posted on Wed, 28 Oct 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 28 Oct 2015 Answered on

Tue, 17 Nov 2015 Last reviewed on

Question : I have taken Losartan 100 mg and HCTZ 50 mg for some time. Recently this has not been controlling my bp, so my doctor added Amlodapine 5mg. Still my bp remains too high, especially my diastolic bp. Now we've added 0.1 mg Clonadine. BP is still not staying within normal limits. Is there a time or spacing of my meds that would help stabilize my bp? I am 64 y/o/f, overweight, but otherwise in good health.

Answered by Dr. Dr. Meriton Siqeca (24 minutes later)

Brief Answer:
Therapy span through day

Detailed Answer:
Hello. Thank you for your question and welcome to HCM. I understand your concern.

I would recommend you that some of the drugs should be divided in halves. A good strategy would be that Losartan and Hidrochlorthiazid should be divided in halves, taken in the morning and in the evening. And this has to be accompanied by amlodipine taken in the afternoon. I have seen this strategy works, in many cases, in my own experience. The blood pressure figures should be kept under 140/90 mmHg. Every figure between 100/60 and 140/90 is considered normal.

Also, if this strategy does not provide a better control of the hypertension, then other drugs should be taken into consideration. I am referring more to the beta-blockers and angiotensinogen converting enzyme inhibitors (ACE-I). You can discuss this option with tour cardiologist.

I hope I was helpful with my answer. Wish you a good health.

If you have further questions, I would be happy to help. Please rate my answer, if you do not.

My kindest regards,
Dr. Meriton

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Meriton Siqeca (27 minutes later)

Should I consider an ECHO if my bp continues to remain high?

Answered by Dr. Dr. Meriton Siqeca (50 minutes later)

Brief Answer:
Welcome back.

Detailed Answer:
Hello again!

Well, echocardiogram is always an option, as a diagnostic procedure, not as a treating one. Hypertension means that heart has to work against peripheral resistance. This means that it, eventually, will be subject to muscular hypertrophy. Thus, a "thickening" of the heart chamber walls is an expected finding in echocardiogram. If you do not have any symptoms, I would not recommend it, at least at this moment. Also, it is a harmless test.

I hope I helped.

Best regards,
Dr. Meriton

Above answer was peer-reviewed by : Dr. Sonia Raina