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Why is blood pressure elevated even after medications?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am a 31-year-old male. I follow a good diet and do physical work. My blood pressure (BP) is 140/90 mm of Hg, and my pulse is 75 bpm. I take tablet Hydrochloride 25 mg, tablet Carvedilol 6.25 mg, tablet Diltiazem 350 mg, and Potassium. Recently, I took an EKG, echocardiogram, stress test, ultrasound of the kidneys and heart with contrast to check my health. Please explain if my health is fine while taking these medications.

I hope this helps.

Thank you.

Answered by Dr. Isaac Gana

Hello,

Welcome to icliniq.com.

I understand your concern. Do you take your blood pressure medications as prescribed? At what time of the day do you usually measure your blood pressure? Do you consume a lot of salt? These factors will determine how best to approach your situation.

Thank you.

Patient's Query

Thank you, doctor,

I take my tablet Hydrochloride 25 mg, tablet Carvedilol 6.25 mg, tablet Diltiazem 180 mg, along with 20 mEq Potassium in the morning, tablet Diltiazem 180 mg, and tablet 20 mEq Potassium in the evening. My prescriptions have changed several times, but it seems never to go down entirely, no matter what I take.

I have been watching my sodium intake and trying to keep it around 2000 mg a day, and trying to be sure to drink plenty of water and no coffee. I have been having this for 15 years. I will lose some weight, but I am not overly heavy. It does run in my family, but I am missing something.

Please guide me.

Answered by Dr. Isaac Gana

Hi,

Welcome to icliniq.com.

If you say you have been battling with this for 15 years, it means you were 16 years of age when you started getting treated for hypertension. It indicates you most likely have secondary hypertension.

  1. Did you use corticosteroids as a child?
  2. Have you ever checked your thyroid function and kidney function?
  3. Is ultrasound and CT (computed tomography) taken for the abdomen?

Did they check your cortisol levels for adrenal glands? Do you know if your mother smoked while pregnant with you? I suggest tablet Hydrochlorothiazide 25 mg (Benzothiadiazine) morning and evening. It should help. When measuring blood pressure, ensure you do it immediately you wake up in the morning, not after doing physical activity. It would help if you had additional investigations to check for secondary causes.

I hope this helps.

Thank you.

Patient's Query

Thank you doctor,

I never took Corticosteroid tablets, as far as I can remember. I did have a thyroid function test and a kidney function test. I do not think I have ever had a CT of my abdomen or cortisone levels checked to get it checked. My mother does not smoke, and I do not either. Also, I do not drink alcohol either. I appreciate your thoughts on this. I am just trying to get another opinion from another doctor to see if maybe we are missing something. I will have to get my doctor to try the other two tests.

Thank you.

Answered by Dr. Isaac Gana

Hello,

Welcome back to icliniq.com.

Yes, please talk to your doctor about the need to do the other investigations. If the source of your blood pressure is found in the future, you might go off antihypertensive medication depending on the cause. The earlier, the better. I hope this helps.

Thank you.

Answered byDr. Isaac Gana

Medically reviewed byDr. Meera Premanand

Published At March 2, 2022
Reviewed AtMarch 17, 2026

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