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Forum Name: Hypertension

Question: High blood pressure that WILL NOT come down


 lgroves - Tue Sep 16, 2008 10:43 am

My grandmother has had high blood pressure for many years and has been on medication for it as long as I can remember (I'm 23 years old). Around 3 years ago, her medication seemed to be doing no good, so her doctor changed medications. The new one worked for a while, then her blood pressure creeped up again. After about a year of this, her doctor sent her to a cardiologist in a larger town. In September of 2007, and after 2 years of this problem, he finally admitted her for testing. He thoroughly checked her kidneys; no problems. He tested veins and arteries around her kidneys, heart, and neck; no blockage. In fact he said she has the veins of a teenager. He diagnosed her with stress, put her on xanax, and sent her home. The xanax made her basically like a junkie as her body did not handle it well. Also after a couple of weeks on xanax her blood pressure went right back up again. The doctor took her off of xanax since it was doing no good and changed her BP medication yet again. Her medication has been changed more times than I can count in the past year and she told me that she has been diagnosed with congenitive heart failure (I believe that is what she called it). Finally, after a year since the testing, he has decided to do a sleep apnea test. She has trouble sleeping and is tired a lot during the day. She also snores, so this is a possiblity. What concerns me is that, even on medication, her BP has been staying around 150/105. For some reason she just really isn't responding well to any medication that she has been on for the past 3 years. She has also recently formed mild cataracts and complains of slight eye pain. She is urinating constantly (not sure if this is just because of age - 72) and has always complained of leg pain and a little swelling in her calves. If it turns out that sleep apnea is not the cause, we are at a loss. We are desperate to save her because we know the effects of long-term high BP like hers. I know 95% of hypertension cases have no known cause, but since hers won't respond to medications it seems that it must be secondary to something else and we're running out of time. If there is anything else that you can think of that may be causing this that I haven't already mentioned, please let me know. Thank you.
 John Kenyon, CNA - Fri Oct 03, 2008 10:04 pm

User avatar Hello -

This must be very frustrating for you and especially for your grandmother. It does happen sometimes, and as you've correctly deduced, it almost always is secondary to something else. Sleep apnea is a frequent culprit, so this may be the answer to the mystery.

If the sleep apnea theory doesn't pan out, the only other thing I can think of off hand that might be causing this (and which probably has been ruled out, but I'm not certain) is pheochromocytoma, which is an adrenal tumor. While these are usually found atop the kidneys and growing on the native adrenal glands, they also can sometimes develop in other parts of the body, so are not always obvious (they can also be quite small and difficult to visualize). They produce additional adrenaline, and this extra "dose" is what causes persisten and often inexplicable high blood pressure.

Given the history youv'e posted here, I have a strong sense the sleep apnea theory will turn out to be correct, and if so, that should lead to stabilization of the problem. If not, and if pheochromocytoma is ruled out, then combination blood pressure therapy is the best likely hope of controlling the problem.

Please let us know how things go with the sleep study and generally update us.
Best of luck to you and your grandmother.

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