Hypertension - Norvasc, Avapro, Synthroid, Furosemide, Pravachol
Posted by The Doctors (doc@flora.org)
46 Hypertension
My husband is currently taking the following medications:
Norvasc 5mg (twice a day) Avapro 300 mg (twice a day)
Synthroid .2mg Furosemide 40 mg (twice a day) Pravachol
40 mg Atenolol 50 mg In spite of this he is unable to lower
his blood pressure below 140/90, Any suggestions?
Answer by Helen Stanbro, M. Phil.
Do they know what is causing the hypertension? Could he have
some kind of kidney problem, for example, or renal artery
stenosis? It would be good to have a cardiovascular specialist
evaluate him to see what is going on. Drug-resistant
hypertension is not that uncommon. Here is a good recent review
that you might be able to find at a medical library or get
through your public library: Mayo Clin Proc 2000
Mar;75(3):278-84
Related Articles, Books, LinkOut
Published erratum appears in Mayo Clin Proc 2000 May;75(5):542
Management of difficult-to-control hypertension. Graves JW
Division of Hypertension and Internal Medicine, Mayo Clinic
Rochester, MN 55905, USA.
Hypertension is a primary risk factor for heart
disease and stroke, the first and third most
common causes of death in the United States. The
National Health and Nutrition Examination Survey (NHANES)
revealed an increase in awareness of hypertension from 51% to
73%, and, among persons with hypertension, the treatment rate
has increased from 31% to 55% (from 1976-1980 vs 1988-1991). Of
importance, the rate of those achieving goal blood pressure (<
140/90 mm Hg) has only improved from 10% in NHANES-II
(1976-1980) to 29% in NHANES-III (1988-1991). Thus, more than
70% of persons with hypertension in whom good blood pressure
control has not been achieved are termed "difficult
hypertensives." Failure to achieve treatment blood pressure
goals of less than 140/90 mm Hg is usually attributed to the
presence of resistant hypertension, a resistant physician,
secondary causes of hypertension such as renovascular disease,
medication adverse effects, or a nonadherent patient. A
practical understanding of the pathophysiology of resistant
hypertension, appropriate screening techniques for secondary
forms of hypertension, and alternative management strategies for
a chronic disease such as hypertension can result in treatment
goals being achieved in most difficult hypertensives.
Publication Types: Review: Review, tutorial
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