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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Increased Blood Pressure Level?

My blood pressure has increased to 151/104 pulse is 65. I ve taken Azor 5/20 and HCTZ (Hydrochlorothiazide) 12.5 for over a year and blood pressure stayed around 125/82. I developed swelling in my hand and middle finger and the urgent care doctor thought it was Gout and put me on Indomethacin 50mg and told me to stop taking the HCTZ. My lab came back negative for Gout, Uric Acid was 6.9 (normal range), but my blood pressure increased. Should I go to the emergency room?
Wed, 5 Aug 2015
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Cardiologist 's  Response
Hello. Thank you for your question and welcome to HCM. I carefully read you query.

Well, at this moment, I understand, you are on a triple therapy for fighting hypertension. First, the amlodipine, which is a constituent in azor, can cause swelling of limbs, most commonly the ankle area, but there are cases, although rare, that it causes also swelling of the wrist area and fingers. In my experience, I would also suspect a gout diagnosis. But, since the uric acid is within range, then this is excluded. Second, indomethacin is a non-steroidal anti-inflammatory drug (NSAID), and just like all NSAIDs, has a tendency to raise the blood pressure by as 20 mmHg systolic. At this time, my opinion is that this is just a side effect of indomethacin. However, blood pressure tends to get higher even if on medication, which controlled it in a past time. I am certainly not saying that this is case. But, if even after two weeks off the indomethacin, you continue to get these blood pressure figures, then I would recommend you to discuss with your general practitioner or your cardiologist, to try raise the now used medication dosage and/or add another anti-hypertensive to your therapy, such as a beta-blocker, which also be beneficiary for your heart, by acting on reduction of heart workload - prolonging the heart cycle - promote a better ventricular filling and a larger amount of blood to supply end-organs.

I hope I was helpful with my answer. Wish you a good health.

Best regards.
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What Causes Increased Blood Pressure Level?

Hello. Thank you for your question and welcome to HCM. I carefully read you query. Well, at this moment, I understand, you are on a triple therapy for fighting hypertension. First, the amlodipine, which is a constituent in azor, can cause swelling of limbs, most commonly the ankle area, but there are cases, although rare, that it causes also swelling of the wrist area and fingers. In my experience, I would also suspect a gout diagnosis. But, since the uric acid is within range, then this is excluded. Second, indomethacin is a non-steroidal anti-inflammatory drug (NSAID), and just like all NSAIDs, has a tendency to raise the blood pressure by as 20 mmHg systolic. At this time, my opinion is that this is just a side effect of indomethacin. However, blood pressure tends to get higher even if on medication, which controlled it in a past time. I am certainly not saying that this is case. But, if even after two weeks off the indomethacin, you continue to get these blood pressure figures, then I would recommend you to discuss with your general practitioner or your cardiologist, to try raise the now used medication dosage and/or add another anti-hypertensive to your therapy, such as a beta-blocker, which also be beneficiary for your heart, by acting on reduction of heart workload - prolonging the heart cycle - promote a better ventricular filling and a larger amount of blood to supply end-organs. I hope I was helpful with my answer. Wish you a good health. Best regards.