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What Causes High Blood Pressure Despite Taking Medication?

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Posted on Wed, 15 Feb 2017
Question: 52 year old male who had triple bypass in March 2015, taking 50mg Losartan 1x day, and does daily treadmill for half an hour
first BP of the day is always high i.e. 157/111, 145/108, with the diastolic eventually going down to double-digits, sometimes feels light headed (mostly mid day or end of work day) and if BP rises again at the end of the day, takes 25mg Losartan which somehow lowers BP reading afterwards
Any thoughts, concerns, recommendations? Thank you.
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Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I carefully passed through your question and would explain that your blood pressure values are a little elevated.

This could be related to physical activity.

Anyway, I would recommend increasing the dose of Losartan to 50mg twice daily, in order to have a better control of your blood pressure.

If your blood pressure values are still over 140/90mm Hg after some days, I would recommend adding Hydrochlorothiazide 25 mg in the morning.

Regarding the dizziness or lightheadedness, I would recommend performing a Doppler ultrasound of the cervical arteries in order to examine the blood flow to the brain and exclude possible atherosclerotic narrowing.

I would also advise you to check periodically your blood lipid profile and some other blood lab tests ( complete blood count, kidney and liver function tests, fasting glucose, blood electrolytes).

Hope to have been helpful!

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 : 9536 Questions

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What Causes High Blood Pressure Despite Taking Medication?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Thank you for asking on HCM! I carefully passed through your question and would explain that your blood pressure values are a little elevated. This could be related to physical activity. Anyway, I would recommend increasing the dose of Losartan to 50mg twice daily, in order to have a better control of your blood pressure. If your blood pressure values are still over 140/90mm Hg after some days, I would recommend adding Hydrochlorothiazide 25 mg in the morning. Regarding the dizziness or lightheadedness, I would recommend performing a Doppler ultrasound of the cervical arteries in order to examine the blood flow to the brain and exclude possible atherosclerotic narrowing. I would also advise you to check periodically your blood lipid profile and some other blood lab tests ( complete blood count, kidney and liver function tests, fasting glucose, blood electrolytes). Hope to have been helpful! Kind regards, Dr.Iliri