Q. What causes a rise in blood pressure despite taking medications?

Hi doctor,

I had consulted with you before also. I am a 65-year-old widowed woman with one daughter. I am hypertensive and put on non-diabetics. First, I used to take three medications: Olmezest (olmesartan medoxomil) CH 20 milligrams, Rozavel (Rosuvastatin) 5 milligrams, and Nexpro RD (esomeprazole and domperidone) 40 milligrams. Taking these three medications, my blood pressure remained normal at 126/84 mmHg. Then, one day, I took a painkiller, and my blood pressure became very high, along with vertigo. So, I consulted with a local doctor, and all these medications were changed. Now, I was taking tablet Cilacar 10 milligrams for blood pressure, tablet Rozavel 5 milligrams, tablet Esoz 40 milligrams, and Levogen for hemoglobin. These tablets I took for the last 12 days. After taking these medications, my blood pressure used to remain at 143/86 mmHg. Today, suddenly, at 8 PM in the evening, my blood pressure became very high to 174/98 mmHg. After this, I took another dose of Cilacar 10 milligrams, but my blood pressure was not coming down. I have had this blood pressure problem for a long time. First, I used to take Olmezest CH 20 milligrams, and my blood pressure used to remain quite normal. But this blood pressure medicine was changed, as my sodium and potassium level was imbalanced after taking a painkiller. Now, for the present time, what must I do to lower blood pressure? Should I take Olmezest CH 40 milligrams for lowering blood pressure? Or should I perform my blood tests again? Kindly help.

Thank you!

Hi doctor,

Thank you for the reply.

Another thing I did not tell you is that yesterday night, after posting my query to you, I called up my local doctor, who prescribed me Cilacar 10 milligrams. I narrated my whole incident, and he prescribed me another BP medicine Benitowa 4 milligrams. Yesterday night, I again took Benitowa 4 milligrams to lower my BP. After taking this medicine, I started having frequent urination at an interval of 30 minutes. In this way, since last night, I urinated nearly 15 times. After this, today in the morning, I measured my BP, and it came down to 145/86 mmHg, and my pulse rate was 88 beats per minute. After this, urination became normal. Now, I am not urinating so frequently. So my question to you is, will I now take Benitowa 4 milligrams instead of Cilacar 10 milligrams if this medicine suits me? Will there be frequent urination if I take Benitowa 4 v? Do I need to perform any medical tests now, like blood, urine, electrocardiogram, or electrocardiograph?

Thanks.

Hi doctor,

Thank you for the reply.

I have been taking Benitowa 4 milligrams for the last two days, but I have been suffering from constipation since yesterday. The urination problem is not there now. My urine is normal now. Currently, I am taking Benitowa 4 milligrams, Rozavel 5 milligrams, Esoz D, and Livogen-XT tablets. I had a constipation problem with Esoz D before, also when I used to take Cilacar 10 milligrams. This constipation has enhanced more after changing to Benitowa 4 milligrams. Sometime back, when I used to take Olmezest CH 20 milligrams, I was prescribed Nexpro RD 40 milligrams, and at that time, this constipation problem was not there, but there was extreme weakness with Olmezest CH 20 milligrams. But after this painkiller issue of mine, all the medications have been changed, and now no weakness is there, but there is constipation. Is Benitowa 4 milligrams a good medicine for blood pressure? Today, in the morning, my BP was 134/78 mmHg, and my pulse rate was 81 BPM. This constipation problem is occurring due to which medication, Benitowa 4 milligrams or Esoz D? Can you prescribe me a solution for my constipation problem? Every day, I go out for work, and in the morning, if I face a constipation problem, then it will really hamper my daily routine. Kindly advise what medications must be taken now. Which medications must be changed now, the BP medicine or the indigestion? I will soon follow up with my recent blood reports.

Thanks.

Hello doctor,

Thanks again.

I am consulting with you after quite a long time. As you know, I am hypertensive but non-diabetic. Regularly, I take the following 4 medications, Rozavel 5 mg, Benitowa 4 mg, Esoz 40 mg, and Livogen-XT. My recent problem is that, since yesterday, while brushing my teeth, when I was cleaning my tongue and applying pressure, I had a nosebleed. I had a bleed today also while brushing my teeth and cleaning my tongue. Then today, in the afternoon, I checked my BP, and it was a bit high, 147/91 mmHg, and my pulse rate was 88 BPM. My BP generally stays in the range of 130/85 mmHg every day. I am quite scared now regarding my nosebleed. Is it something to worry about? Kindly advise. I had my last medical test done four months ago.

Hello doctor,

Thanks again. As you know, I am a hypertensive but non-diabetic woman. My age now is 65 years. Every day, I am taking the following medications, Benitowa 4 mg for BP, Rozavel 5 mg, Esoz 40, and Livogen-XT. My BP generally stays in the range of 135/85 mmHg. A few days ago, as I had told you while brushing, I had a bleed but did not go to the ENT doctor. At that time, my BP was 150/95 mmHg. For two days, I had a nose bleed, but after that, my BP came down to normal. This happened at the start of this month. After this, I did not have a nosebleed. But yesterday, suddenly, in the evening, my BP rose to 160/100 mmHg. So, after taking Benitowa 4 mg, I took 1 dose of Cilacar 10 mg. Today in the morning, my BP was the same. So, I took 1 dose of Olmezest CH 40 mg to lower my BP. Today, in the evening, my BP came down to 140/91 mg. So, I did not take Benitowa 4 mg. At 12 AM night, my BP again began to rise to 149/99 mmHg. Immediately, after this, I took Benitowa 4 mg. I will wait throughout the night and see what happens in the morning. After retirement, I am going through stress and tension regarding my unmarried daughter. I do not know whether these fluctuations in BP are occurring for that or not. I am really scared regarding this fluctuation in BP. Is it something to worry about? Can this fluctuation in BP occur due to Livogen XT? I have been taking it for the last six months. Do I need to perform any medical tests now? After retirement, I am really missing my workplace. Kindly advise what I must do now regarding my fluctuations in BP. Will I become alright? Will I continue with Benitowa 4 mg? If tomorrow morning, my BP does not come down, then what must I do? I am urinating normally after taking BP medications. Can these fluctuations in BP occur because of indigestion, as I am mostly at home? You know in the last few days, my eyes have become a bit red.

Thank you doctor for the reply,

I regularly take the following medications: Olmesartan Medoxomil + Chlorthalidone, Rosuvastatin, Esomeprazole, Clonazepam, and iron, folic acid, and zinc tablets. My blood pressure has now become normal. Last night, it was 121/76 mmHg, with a pulse rate of 77 BPM. I have been taking Clonazepam 0.25mg for the past two months, and since last week, I have been experiencing stomach ache and gas after taking the medication. My appetite has also reduced. I do not feel hungry at night, and most days, I skip dinner. My urine and stool are normal, and there is no constipation.

Could the stomach ache be due to the side effects of Rosuvastatin or Clonazepam? I am attaching my recent medical reports for your reference. Additionally, in my recent ECHO report, some findings indicate concentric hypertrophy. Are these findings worrisome? Please advise on what I should do about the stomach ache and gas.

Thank you.