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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have leg muscle spasm and high blood pressure. Taking apresoline. Why is it not getting controlled?

Answered by
Dr. Nsah Bernard

General & Family Physician

Practicing since :2012

Answered : 1704 Questions

Posted on Fri, 1 Feb 2013 in Hypertension and Heart Disease
Question: what could be the cause for high blood pressure that wont go down with medicationbeen going on for 1&half years im now on apresoline have to see another cardioliest have leg muscle spasms when i lie down
Answered by Dr. Nsah Bernard 2 hours later

Thank you for posting your worry.

Proper management of high blood pressure is multidisciplinary including use of drugs (up to 4 and at times 5), diet (salt, oil, alcohol use etc.), lifestyle change ( exercising, eliminating stress, etc.).

First, your doctor had to eliminate all possible causes of secondary hypertension that could result to resistant hypertension. Secondary hypertension is when there is high blood pressure secondary to other underlying disease conditions like kidney diseases, endocrine diseases, cardiac diseases, tumors, thyroid diseases etc. (the list is long and this could be triage by your doctor according to your own clinical and paraclinical presentations). These causes can be corrected medically and so needs to be treated first.

In the other hand, if we are sure that you are having primary/essential hypertension (which has no specific cause or unknown or no cause), then by definition of resistant hypertension (which is blood pressure which remains above goal/target value despite concurrent use of 3-4 antihypertensive medications of different classes with at least 1 diuretic and all in their optimal doses.), we would have to make sure that you are actually on 3-4 antihypertensive medications, proper medication adherence, you have adjusted your diet, you perform at least a 30 minutes walk day/ exercising, eliminating medications that could increase blood pressure and other lifestyle changes which are aimed on naturally bringing down the blood pressure.

So, if you feel you have more information that you can provide to help us better understand your own situation and see if they are specific things we would need to add.

Also, given your age, resistant hypertension is often a common problem in clinical settings and so your doctor will have to adjust your treatment regimens with different classes of drugs until he/she can find the proper regimen that can bring down your blood pressure below goal value. Different people react differently to different antihypertensive drugs.

Hope the above info was helpful and please do not hesitate to write back if you have further questions.

Nsah, MD

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