9 Tips Resistant Hypertension

What if someone is taking medications and yet the blood pressure refuses to come under control? Medically speaking, hypertension is said to be resistant only if blood pressure does not go down to normal limits despite medication. While one single drug is successful in reducing the blood pressure in 50 to 60 percent of patients, with the use of two or more medications, the blood pressure reduction can be expected in 85 to 90 percent of patients. Physicians often refer to patients as having resistant or refractory hypertension if the blood pressure remains high despite taking two or three different medications in the usual doses.

Questions to ask if you have Resistant Hypertension: It is not that nothing further can be done to lower blood pressure if a person happens to have resistant hypertension. Check the following to see if your High blood pressure is resistant to the usual treatment:

1. Is the prescribed medication being taken sincerely?
2. Are appropriate doses of the pills being taken? If the doses are too small, you need to take appropriate action. If by mistake you took only half the dose of a blood pressure –lowering medication, your blood pressure is not likely to respond satisfactorily. Unfortunately, these innocent errors are all too common.
3. Is your lifestyle interfering with the control of blood pressure? For example, if you are going through an unusual period of stress in life, the usual doses of antihypertensive medications may not be sufficient control blood pressure.
4. Is there too much salt in the diet? Although not everyone is not salt sensitive, between 40 to 50 per cent of adult are known to be highly sensitive to salt intake. In salt sensitive people, the blood pressure goes down by 5 to 15 mmHg within a few weeks of reducing the salt intake.
5. Is too much caffeine being consumed? Excessive caffeine consumption can easily affect blood pressure. Adults taking more than four cups of coffee per day may notice that their blood pressure goes up by 5 to 10 mmHg.
6. Is there excessive alcohol intake? While one or two drinks per day are considered to provide cardiovascular protection, excessive drinking is known to raise blood pressure. If blood pressure is not responding well to the medication, it is worthwhile to reduce alcohol intake to not more than one drink per day. A better approach may be to stop drinking for a few weeks and monitor whether this helps in lowering the blood pressure to desirable levels.
7. Is some other medication being taken which possibly interferes with the control of blood pressure? Hypertension is considered to be an age-related problem. Unfortunately, several other diseases including arthritis, diabetes mellitus, obesity and heart disease are also common in the later year of life. Not surprisingly, many adults in their late 50s and 60s are forced to take one or more pills. Commonly used medications for arthritis, such as non- steroidal antiflammatory agents, may cause salt and water retention and thus interfere with the control of hypertension. Even the newer agents, such as cox-2 inhibitor (Rofecoxib and Celecoxib) may also contribute to a rise in the blood pressure so, if you think you have resistant hypertension, discuss all your current medication, including the ones that you bought over the counter (non-prescription), with your doctor.
8. Has there been excessive weight gain during the recent month the weight gain may have happened due to a combination of factors including declining physical activity and increased caloric intake. If you have gained 5 to 10 kg during the past 6 to 12 months, this weight gain alone could explain the difficulty in controlling your hypertension.
9. Is it possible that three maybe secondary hypertension between 10 to 20 per cent of patients with resistant hypertension have secondary hypertension. If your blood pressure fails to respond to a combined treatment with 2 to 3 different blood pressure pills, the question of secondary hypertension must be entertained. Depending upon the clinical examination, it is only for the doctor to rule out those secondary causes.