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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Switched from Clonidine to Hydralazine for BP, ever since have rebound hypertension and headaches.Is this serious?

I was on Clonidine and Lopressor for my blood pressure; the doc took me off of clonidine and put me on hydralazine; I ended up in the hospital with rebound hypertension, he then put me back on a low dose of clonidine and weaned me off. I am now on Lopressor twice a day and hydralazine 3 times a day and my blood pressure still isn't back to normal. I have been taking it for over 5 days now. How long does it take for my BP to get back to normal. I have been having headaches especially in the back of my head. BP readings have been; 161/88 pulse103; 158/93 pulse 90; 158/97 pulse 93; 157/96;pulse 88; 167/95 pulse 85; 170/98 pulse 98; 150/91 pulse 93; 185/124 pulse 86 these are readings over the last 3 days including today.
I am thinking the meds aren't working. Your opinion please. Thanks Mary Lee

Sat, 30 Nov 2013
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Cardiologist 's  Response
Dear Mary,

Thanks for the query. Hydralazine is a third line anti-hypertensive, difficult to comply with since it is scheduled 3 times daily and if you miss doses the concentrations go down quickly; it would be quite reasonable in your case to consider other easier, more potent medications, such as amlodipine 10 mg (probably the strongest blood pressure medication in steady state and well tolerated) and diuretics such as chlorthalidone 25 mg. My best guess judging by your numbers is that you will need at least 3 medications to control your blood pressure to less than 140/90 consistently.
Please discuss these options with your provider; it can take up to 2 weeks when a new medication is started to see full effect.

Hope that helps, wish you the best,

Dr Brenes-Salazar MD
Mayo Clinic MN
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