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What Causes Elevated Diastolic Blood Pressure Level?

Posted on Mon, 16 Feb 2015

Question: I am currently experiencing a very high diastolic blood pressure reading 155 my systolic is 230. This elevation is not unual, but my .Dr. doesn't want to adjust my medication becuase he thinks, and it's true during the day it is very low. Especially when I go in to see him/ Nights are always bad. I do not go to ER because while I lay there it comes down. It's scarry, this is the highest diastolic pressure I have ever had. Howev er it frequently is high, and over 100. I take an extra clonodine, and wait for a half hour or so and if it hasn't come down I take another. I have seen a cardiologist, but it seems when I go to see the Dr. during the day my pressure is good. A huge dilema

Answered by Dr. Noble Zachariah (1 hour later)

Brief Answer:
Requires a 24-hour monitoring by ABPM

Detailed Answer:
Hello,
Welcome to HCM and thanks for your query.
I understand your concern.
Have you had an ambulatory blood pressure monitoring? It would show your BP record through out the day. Clonidine can produce a rebound elevation of blood pressure if you miss the regular dose.
I shall be happy to offer you a remote monitoring of your blood pressure athttp://www.drnoblezachariah.com/home/health-monitoring
It is free now and I'll be able to advise you better.
Take care,
Dr Noble Zachariah

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (15 hours later)

I have done this but of course it showed nothing significant

I would be happy to try again. I do take clonodine everynite, and when its that elevated I take an extra dose. Sometimes before my normal bedtime dose of meds. I can feel the rise in BP and when it reaches that le el is when I take the extra dose

Answered by Dr. Noble Zachariah (4 hours later)

Brief Answer:
Please let me know the medicines and timing

Detailed Answer:
Please upload your ABPM result.
You may require to modify your treatment in response to the fluctuations. Please let me know your current medicines including the time you take them.
Often people require several medicines at different times to maintain a near normal BP throughout the day.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (2 hours later)

I take at about 7:30 am acebutelol, zestril hctz, nexium, tramadol, B complex, d3, . At10:30pm I take clonodine, acebutelol, zestril (lisonopril hctz), 1/2 tablet clonazapan, 80mg. Asprin,. I also cranberry capsels, 3 times a day

I have a Drs appt. Mon. by my primary care physician. His answer ALWAYS is. He can't alter my medications because of daytime lows. At 10:00 am my blood pressure was 110/60. Looking for any help my evenings are a nightmare. And I am afraid to go to bed until I get a significant drop. I do take extra clonodine at 1/2 hour intervals. if it isn't coming down. Per Drs. Advice.
,

Answered by Dr. Noble Zachariah (39 minutes later)

Brief Answer:
Try adding short acting anti hypertensive at night

Detailed Answer:
The way to tackle your problem is to use a short acting antihypertensive like hydralazine at night. The effect last only 6 to 8 hours. Omit the morning dose of acebutol and see how your day time BP is. Some adjustments of doses may be required .

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (7 minutes later)

Oops. I forgot to tell you 9 years ago I had a renal artery stent in my left kidney. Didn't help one bit. Much appreciate your quick answers and advice

Answered by Dr. Noble Zachariah (17 minutes later)

Brief Answer:
Try my suggestion regarding a short acting drug

Detailed Answer:
Thank you.
Hope my suggestion would help you to have smoother control of the blood pressure.
Wish you good health and a good day
Dr Noble Zachariah

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (7 hours later)

Thank you.

Answered by Dr. Noble Zachariah (1 hour later)

Brief Answer:
You are welcome

Detailed Answer:
You are most welcome.
I shall be happy to answer any query you may have in the future.
Wish you good health
Dr Noble Zachariah

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar