Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
Tags: high | blood | pressure | medications | beta | blocker | calcium

Meds Won't Lower My BP

Tuesday, 01 May 2012 09:15 AM

Question: I’m taking the beta blocker Toporal for high blood pressure along with the calcium channel blocker Norvasc. But my BP is still 151/70. As you can see, my systolic reading is still high. Is there anything further I can do about this?

Dr. Hibberd's answer:
Are you taking your medications regularly, as prescribed? Uncontrolled blood pressure (hypertension) is seen among those who have poor adherence and/or an inadequate treatment regimen. If you take your medicines regularly, then you probably need a third blood pressure medication to be added. The American Heart Association (AHA) scientific statement notes, populations are becoming older and heavier, and older age and obesity are two of the strongest risk factors for uncontrolled hypertension. The cardiovascular risk is increased in a history of long-standing, severe hypertension complicated by multiple other risk factors such as obesity, sleep apnea, diabetes, and chronic kidney disease. You need to be evaluated by your doctor for the presence of these risk factors. You must provide a detailed medical history including duration, severity, and progression of the hypertension; treatment adherence; response to prior medications, including adverse events; current medication use, including herbal and over-the-counter medications; and any other symptoms which might be causing persistent high systolic pressure. A low-salt diet, moderate consumption of alcohol, and regular exercise to keep obesity at bay is advised.

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When blood pressure does not respond to medication, a careful evaluation needs to be done.
Tuesday, 01 May 2012 09:15 AM
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