This is for everyone. It is very long, and perhaps at your leisure you can read it and gain some information. I am thorough in all my investigation of disease, and this time was no exception. In the past, I have had 3 cancers, and successfully came through them with prayer, positive attitude and visualization. I had a child after doing jin shin (acupressure) when 4 of the best dr's in nyc told me it was impossible due to fibroids and adhesions. I still don't have the exact answer to my hypertension, but I am getting closer by the day. My insurance paid a lot of my visits and tests, and some I had to pay out of pocket. I hope that even one thing in here will help you find the answer to your hypertension. I do feel that more than 1 medication to control the bp is cause for concern especially if it is elevating it. Push for tests, that is my biggest message.
I am not a proponent of medications; I am scared to death of them. I am 56 and do look much younger too. I was thin my whole life, and when I went into menopause about 10 years ago, I actually had no hot flashes. However, i did have other symptoms I wished I hadn't ignored. They were PMS symptoms. I was irritable, had mood swings, terrible cravings and weight gain. Even after I had my daughter at 42, I went right back down to 103 lbs within the first month, so for me, 5lbs was a huge weight gain. I ballooned up to 150lbs and it wouldn't budge no matter how many diets I tried. I had a complete cardiological workup in January 09, and everything was normal except for my cholesterol which was up to 205.
The tests I had were: EKG, 24 hour holter monitor, 24 hour bp monitor (my lowest bp was 109/62 and higheset 128/76), echocardiogram, carotid ultrasound (because when I layed down on my right side, I could hear my heart beat in my ear; I have a relative that started that way and then the heartbeat in her ear was all the time; she had fibromuscular dysplasia of her carotid artery - it is a narrowing but none one caused by atherosclerosis). I also had a stress/echo (while on the treadmill, they take your bp and then you do an echocardiogram afterwards).
Bear with me, as I want anyone with uncontrolled bp to demand tests from their doctor or find one that will give you the tests and tell him so! In Feb 09, I had a cyst in my breast and had it biopsied. It was a benign fibroadenoma. The surgeon put in a titanium clip (she said it was hypoallergenic, but at this point I'm still not sure).
Suddenly in June, I went to a periodontist for some gum problems, and he took my bp before doing the exam. It was 158/98. I thought that highly unusual, and figured it was anxiety. He insisted I see my cardiologist. He happened to be on vacation, and I monitored my pressure for a week. I was getting hideous numbers on my omron like 162/104 and the like. I saw my dr's partner who took all of 5 minutes, and he said my pressure was 130/100 - my machine didn't calibrate with his. So I started not to worry. He prescribed diovan hct. Right in my chart it said I was allergic to sulfa drugs (amongst many others), and the diuretic part (hct) had sulfa in it. So I called really irritated and told him I wouldn't take it. In the meantime, at home, my pressure was ever increasing. I went to the ER one night at 5pm with a bp of about 180/115, and I'm sure it was a lot higher when I got there.
What is peculiar to me is that every book and dr tell you that when you take your bp you should be relaxed and sitting for 5-10mins before you take it. In both hospitals I've gone to with elevated pressure, they put the cuff on and ask a lot of questions. I could barely talk because I was so nervous, so I don't think their readings were accurate. The first time I went, the dr told me to just take the meds - this time straight diovan without the hct. I was cold and then hot and I felt a burning in my head. I told him to do some basic blood work and it came back fine (after 5 hours of waiting).
I still knew something was wrong, and when my dr came back, he ordered a different medication forme to take, and I sat him down and said "look, you did all these tests in january, and it is now july, how did my pressure go from normal to these high numbers." He was concerned, and then I mentioned I had been in menopause 10 years, could that have something to do with it? He didn't even realize I could possibly be in let alone for 10 years. He said "you know when you go through changes your bp and cholesterold change a lot". They hadn't in the 10 years, but now they had. He said he'd do more blood work and I insisted he check my renin-aldosterone levels. I had read an article by the dr who discovered this connection to high blood pressure. He was Time magazine's man of the year. So I also asked the dr for some other tests and then had my gynecologist order a hormone panel including Vit D3 levels. I had read that low vitamin d levels could also cause high blood pressure.
When all the testing came back, it showed high aldosterone levels, and almost zero estrogen and progesterone. My vit D levels dropped from 39 (50-55 is a good baseline and you can go up to 110), to 23. Not good. FYI: if you have your blood tested at Quest labs, you are supposed to divide the number you get by 1.3 for your true levels.
At that point, I told the doctor that I would NOT try any meds, until we figured out why my aldosterone was up. He ordered a renal doppler ultrasound which concluded that their was a blockage in my left renal artery. Sometimes they can be wrong, so they ordered an MRA with gadolinium (I am allergic to ct dyes, so i couldn't have an angiogram, and I preferred the MRA because of that). In order to have gadolinium, make sure you have very recent blood work that checks your egfr values (they indicate whether your kidney function is normal). If it isn't, there is a chance you can have a severe reaction for which currently there is no cure (your body hardens and turns to stone). They only found this out after several cases of people with kidney problems and those who didn't realize they had kidney problems developed the disease. Mass General is trying to find a cure for it, but so far they haven't.
My test indicated that the inferior left artery showed thickening most likely due to artherosclerosis, but the artery was looped (like when a garden hose gets a dent in it is what I was told). They still indicated that in order to see the % of the block, they'd have to do an angiogram, and with my allergies to drugs, they didn't think it was advisable. Angioplasty sometimes works (with renal artery stenosis, you can have a stent put in and have serious complications; or the blockage could occur again within 3-6 months and you can still have high blood pressure). They told me it would not prolong my life from what they read in recent studies. So they decided to treat with bp meds.
In addition, I had a 64 slice cat scan to check my calcium scores (that is also a good check on the heart and its function as well as any potential plaque build up - the higher the calcium score the more likely the plaque - an angiogram of the heart would be a more definitive test). I had a chest xray (since I hadn't had one in years, and it showed a fat pad around the heart, so they did a cat scan which showed an undetected lung matter - either a bronchitis or pneumonia that never healed or TB!). I knew I didn't have TB as I am not a smoker, and the test proved that.
On the MRA, it also showed lesions (hemangiomas) on my liver and lower lumbar spine (I was beside myself as I don't drink either), and an adenoma on my adrenal gland. The left one on top of the left blocked renal artery. I had been feeling anxious the previous months and just not myself. I had also suffered bouts of insomnia since I went into menopause averaging 2-6 hours of sleep. I did extensive driving as well. And was eating in the middle of the night from all the stress. No wonder I was falling apart. My other big concern, which should have been an eye sore to the doctor, was that in 2.5 weeks, I shed 25lbs. Yes, I was nervous, but in 10 years of strict dieting and not having lost more than 2-3lbs, this should have been a concern. I've kept the weight off, and I discussed the lesions on my liver with my gastroenterologist who was very adamant about me doing an upper endoscopy and colonoscopy since I hadn't ever had the former, and had the latter about 15 years ago. However, he can't do either without my bp coming down first as no anesthesiologist would touch anyone with uncontrolled hypertension.
I made an appointment with an endocrinologist to do a 24 hour urine test and more blood work. In the urine and blood they test for adrenal disease by measuring epinephrine, norepinephrine, serotonin, dhea and she also tested my inflammation markers (again) cardio crp and c-reactive protein (all of which can cause high blood pressure - inflammation does that), and vit d3 (remember not vit d2) D3 is what you get from being in the sun - you can get up to 20,000 units from one day in the sun which is a good thing. I never was one to sit in the sun as I had a melanoma years ago in my fingernail so I avoided it. But this time, I went in the sun on 2 random days, and both times, my bp dropped to 120's and 130's over 80's. That was very low for me. When I exercised, my bp dropped initially to 119-120's/80's. But now it doesn't budge much - maybe to 140's.
I fought the dr's tooth and nail not to take meds, but they insisted since my pressure was raising to 160's, 170's, 180's. I tried the lowest dose of norvasc (2.5mg) since they give that to pregnant women. Within 2 hours I got a severe headache and my bp was up to 230/135. I went to the ER, and they were dumbfounded. They kept me there for 3 hours until it lowered to 178/94. I was so angry that I felt worse than without meds. They tried plendil (same family of calcium channel blockers) and same reaction. Next they tried lisonopril, but I refused to take it since the pharamceutical insert said "do not take if you have renal artery stenosis". The dr insisted it should not be taken only if you have bilateral stenosis (both kidneys) . I called the manufacturer of the drug and they said it didn't matter - if you had it in or both arteries, you shouldn't take it. The last one the cardio recommended, which someone mentioned, was doxysosin (which I haven't tried as I was too scared of the potential for fainting or dizzyness). It was only 1 mg and since I go to bed between 1-2am and am up at 5am to get my daughter to school, I felt it wouldn't work for me (the dr told me to take it at bedtime). My neighbor is on it for his prostate (1mg), but had to stop it, as it dropped his pressure so low he couldn't drive. He got off it.
Since I had the adrenal tumor (which I had to point out to the cardiologist and vascular surgeon) - it was right on the MRA report, but they did not concern themselves with it since it was NOT a cardiological issue - they said I should try aldactone (give to people who have adrenal problems and also teens with acne and men who are balding - go figure). I had such high hopes for this medication, but within 3 hours the headache was simply unbearble. I was crawled up in a ball with pain - I took 400 mg of motrin despite the fact that you shouldn't if you have hypertension - and it didn't put a dent in the pain. It was confined to the left side of the head, face and jaw. I couldn't wait for this pill to get out of my s ystem. My bp went up over 200 again with a diastolic of 133. I had had it. I felt that unless something was done with this blocked artery that there would not be a fix for my hypertension.
I had tried acupuncture, jin shin (acupressure), massage (cranial made the pressure go up and gave me a severe headache), resperate (don't waste your money), relaxation, pranic healing and chiropractic (NUCCA) the one that is supposed to work in one treatment (with a slight adjustment - no popping or cracking). The chiro charged me $795 with 2 sets of xrays, a special p illow and said my atlas was completely out of whack and I had a reverse curve (I did have to say that after the adjustment, I felt like the blood was flowing through my brain better, however it didn't reduce my pressure). I didn't go back because it was an hour and 15 mins away from my home, and the dr, get this, wanted $4100 up front for unlimited visits for 1 year. I said "are you kidding me?" - who has that kind of money to put upfront in this economy? And he very arrogantly said "my practice isn't hurting; maybe you should give up camp or lessons for your daughter" (and what fill his pockets?). I went home and called the doctor who ran the study (the head of the hypertensive unit at the cleveland clinic who worked with the chiropractor who initiated the study), and he said that they had monitored people for 3 months and so far it worked, however, there was no long term commitment and more studies need to be done. I also tried raw natural cocoa (which apparently keeps the Kuna indians in Panama healthy and none of them have high blood pressure; the testing was done in conjunction with Harvard - they took the indians to another part of Panama and took away the cocoa and their bp elevated). I tried it and the first day it worked by bringing my bp down to 120's but the second and third days, it didn't budge it. I was so ecstatic the first day, I thought I found the cure! Sad....

I have recently read about the purple sweet potato grown in Okinawa that may be the answer to hypertension. The people there all live to be over 100 and have no heart disease or cancer. They attribute it to the purple sweet potato. So the Univ of Kansas is trying to make a purple sweet potato with purple skin as well, and they are very optimistic that this will help with hypertension. We'll see. I'm going to order a unit from Hawaii or see if I can find some in a Japanese specialty shop. It's worth a try.
I have since increased my Vit D3 to 5000 units a day (per the endocrinologist and this is a normal amount for most people, especially women, to take; I might have to increase it to 10,000 units depending on whether or not it brings my levels up) as this might be a potential factor in the hypertension . Secondly, I went to a dentist to see if an old crown I had root canal done with could be causing the headaches and have an effect on the bp - there is scar tissue there so they will watch it (and I do remember the pain it caused years ago when I had an abscess there). Then I made an apptment with a neurologist (I booked him in august and the earliest I could get in is November 3). I also saw an eye dr to see if the hypertension has caused damage to the retina, and he said the vessels are beginning to show signs even though I have only had elevated bp since June). It is all so frightening.
The biggest thing I did was call Dr Laragh's office - the Time magazine man of the year whose article got me going on my quest for answers. He is still head of the cardiovascular unit down at Cornell-Weill in NYC, but he is semi-retired and teaches; however, he read my email (which I was very impressed with), and he had one of his dr's call me. All of his drs were trained under him with at least 17 years of experience. This is all they do - deal with people with elevated renin and aldosterone and blocked arteries. I am seeing the dr tomorrow (i had to wait one month but they got me in as an emergency since they were booked well into 2010; they determined, based on all my tests, that I needed to be seen asap). I haven't told my cardiologist yet, as I want to see what they say and suggest. If they think surgery is an option (which I am not keen on due to the risks and complications; however, if it is a one time experience and could keep me off meds, I think I may consider it. If I didn't have the allergies, and the artery wasn't looped, I would do it but there are too many other factors to consider).
So my message? PLEASE PLEASE PLEASE keep at your doctors. Ask for more tests, bring in articles and studies to show you are empowered. Ask lots of questions. I, too, had a nurse practitioner who cornered me and told me if I didn't take the meds, I would wind up in renal failure 100% for sure and then my daughter would grow up without a mother. I hammered back and said I know my body, and I won't stop until I get answers. I told her I had been under monumental stress for the past 10 years, and with all that my bp never rose. She laughed and muttered and I heard her telling the dr that and she said "10 years ago, her bp was 120/80, so it must have been starting then..." She didnt' realize I had been in the ladies room next door. So I walked out and said, then if I had what you consider high blood pressure then, I would think this practice is responsible for not telling me or advising me to go on bp meds! Then I told the dr I would no longer deal with her, and he said that would be fine. So speak up.
Good luck to everyone!