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6 Reasons Your Hypertension Meds Might Not Be Working

From the Cleveland Clinic

A hypertension specialist looks at potential causes. Usually, it’s not just one single issue but various factors that contribute to the problem. Your doctor will work to figure out why – and from there, create a new plan of attack.

“Finding the right combination of medications for uncontrolled hypertension may require some trial and error,” says hypertension specialist George Thomas, MD.

In his work with patients, Thomas investigates possible explanations for difficulty in controlling blood pressures. These can include:

Reason 1: You could be experiencing ‘white coat’ hypertension

If you feel nervous about seeing a doctor, your blood pressure could spike at each appointment and give the false sense that your blood pressure is generally high.

Try arriving early at your appointment, then take deep breaths in the waiting room to relax. Work to manage your anxiety. The American Heart Association recommends that you sit quietly for at least five minutes before taking your blood pressure.

Reason 2: You might not be taking medications correctly or you could be taking other drugs that interfere.

With complicated dosing schedules, people can forget to take medications or not take the correct doses at the correct time intervals.

Also, other drugs can interfere with blood pressure control, including pain relievers (NSAIDs), oral contraceptives and nasal decongestants. That’s why it’s good to bring all of your pill bottles, including over-the-counter medications or vitamins, to your appointments.

Reason 3: You or your doctor’s office could be making mistakes in testing

Sometimes, people make mistakes in testing at home. Bring your home unit to your appointment and show it to your doctor to make sure it’s operating correctly. Make sure your arm cuff is the appropriate size for you. When you take readings at home, start by sitting quietly for five minutes. Then, be sure your back is supported, your feet are on the ground, and your arm is at heart level to get an accurate blood pressure reading.

Misreadings can also happen at your doctor’s office, says Thomas. The cuff might be the wrong size, or they might be taking a reading before you’re fully at rest.

To get a more accurate reading, Thomas takes six blood pressure readings in a row, each one minute apart, using an automated blood pressure machine. He or his staff observes the first reading but then you are alone in the room for the remaining five readings. They use the average of the last five readings to get the result.

Reason 4: You might be eating an improper diet

Thomas recommends the low sodium DASH diet for patients with hypertension — lots of fruits, veggies, whole grains and lean protein, with no more than 2.3 grams of sodium each day. You should check with your doctor if the DASH diet is appropriate for you.

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