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What causes spike in BP despite being on medication? - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
User:I have a high blood pressure since 1987 and been on medications and Dr. check up. I have an expensive blood pressure tester at home which I am using it randomly. My regular measurements till 14 days ago were 138/92 or 139/95. I know these numbers were normal for me. But for the last 14 days, I am light headed which I know my high blood measurements are high. i.e 172/100 or 174/102. I am still taking the same prescriptions which are Benazepril 20 mg and Triamterene-hydrochlorothiazide 37.5 - 25 mg. Can you help me with this? Or what other medicines are good to lower my high numbers. I know they are tons of medication that can help me. Thanks
Doctor:Hi, I am Dr. XXXXXXX
Let me read your query for few minutes to be able to have a good discussion here.
Doctor:May I know if all these high readings were documented on a single day?
User:Its been for the last 3 days but I was feeling a bit light headed for the last 10 days which I thought it was my tireness.
Doctor:Besides the lightheadedness and the tiredness do you have any other symptoms such as fever, low appetite, body ache, nasal congestion or any other unusual symptoms?
User:May be my body got used to these medications and they lost their effectiveness.
Doctor:Are you with me?
User:No Doctor, I do not have any other symptoms. Funny thing is that yesterday I was at Giant Super market where I decided to check my readings where they showed up 181/110, ofcourse that upsetted me, I rechecked again at home, they were same. These were taken around 430 pm and 0600pm respectively. By 1045 pm I decided to check them again, and this time it was normal 138/79. But today I am back to high numbers. Any ideas doctor?
Doctor:Let me brief you.
Doctor:Drug tolerance is widely associated with anxiety, depression and other medicines used for neuropsychiatric disorders.
Doctor:As far as blood pressures are concerned, it is most likely the progress of hypertension that leads to high numbers.
Doctor:if you been very religious with the treatment, I would increase benazepril to 40mg once a day
Doctor:than trying a third or probably fourth antihypertensive medicines.
Doctor:Stressors have its impact on blood pressure.
Doctor:You need to improve the life style - reduced salt and some more exercise.
Doctor:you can try the changed dosage after talking to your treating doctor.
Doctor:Did you follow what I said? Can you summarize our discussion?
User:Yes, I follow you very good. I have been this route before and I will take your advise seriously. Shall I see my regular primary doctor or Cardiologist?
Doctor:A cardiologist would be the ideal choice. But if you have been associated with the physician for long time, you can discuss with him before seeking a cardiologist opinion.
Doctor:I am sure the doctor would agree with increasing dosage now.
Doctor:Do you have any more questions?
User:No, thanks.
Doctor:Thanks for visiting me here. I wish you good health. Bye for now.
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