Patient : I am 38 year old female. I have high blood pressure.I have taken 3 different blood pressure medicine and also a byostolic and none has helped not even a little. My question is, what could be wrong that the medicine wont help? Could having high chlosetoral be why the medicine hasnt worked?
Hypertension treatment guidelines follow the ACD rule. In someone of your age, initial therapy could be with either an ACE inhibitor (Lisinopril) or Angiotensin receptor blocker (ARB) or Beta-blockers (Nebivolol). Beta-blockers are no longer first line but may be used as additional therapy usually if a patient has angina, history of previous heart attack or heart failure. If your blood pressure is not optimally controlled on one agent, the addition of either a Calcium channel blocker or a Diuretic should be the next step. There are many lifestyle measures that can be modified to lower blood pressure (BP). These include: Weight reduction with a target Body Mass Index of <25; reduced sodium intake <100mmol/day = 2.4g sodium; increased daily physical activity minimum of 30 minutes/day, limit alcohol intake <3 units/d for men, <2units/d for women; smoking cessation; reduced saturated fat/cholesterol intake, adequate calcium and magnesium dietary intake and adequate intake of dietary potassium approx 90 mmol/d. The DASH diet (Dietary Approaches to Stop Hypertension) has been promoted by the National Heart, Lung and Blood Institute. I advise discussing this with your family doctor, if you have further queries.
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