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I am a 38 years old male having high blood pressure and Now doctor advise to taking a tablet every morning and evening called LOTENSYL 10mg,Storrvas 10mg,minipress2.5mg Arkarmin ,phostat trice in a day and Febutaz 40 before sleeping. most of time Bp has 150/90 at morning,evening quite high like 160/100 ,PR 86. Lipid profile TC 190. HDL - 34mg/dL, LDL - 104.0 mg/dL, VLDL - 52.00,TRIGLYCERIDES- 306.00 mg/dL.

PAST HISTORY : i have hbp sine from 4 year back.most of time my bp has 150 /100 pr 70 - 86,i have seen cardiology and nephrology. all are fine but creatinine slightly high 1.36 mg/dl GFR Total:68.8 ml/min.

2 Answers

Dr. Puneet Madan answered : 12 years ago

Hi,

You seem to be having more chronic and resistant kind of hypertension. That is why you have been prescribed so many drugs involving so many systems.
You are having some kind of renal failure also,that might be the probable cause for your resistant hypertension.

I think you should go for a second prescription cause some of the drugs prescribed to you are very old. Rest all your test seem to be normal except for kidney function,for which you should be prescribed some other drugs,and some other drugs should be removed.

Get your diabetic status also checked,urine test for proteinuria,test for kidney structure also. ( Or provide me with your above test)Cause many times gfr might not be very accurate.

Feel free to ask further questions

Patient asked followup Question: 12 years ago

here i have done some test are BUN 9.00mg/dL,Creatinune 1.36 mg/dL ,Sodium 143.00 mEq/L, Poassium 4.10 mEq/L, VMA 24 hour urine VMA- 3.42 and Creatinine 63.71 mg/dL . DTPA also done Bilateral Kidneys appear normal in size shape and placement. Bilateral perfusion and renal cortical trace uptake is preserved. Bilateral intrarenal pareachymal transit time is normal with good drainage seen from the bilteral pelvicalcceal systems Differential Renal function Left 49.69% Right 50.31%,GFR (Total 68.8ml/min) Left 34.19ml/min, Right 34.61ml/min. Urine examination routine Protein/Albumin is (+++) 300 mg/dl, CT report of whole abdoman ( Bilateral adrenal glands are defined and appear unremarkable)and ultrasound KUB are good.

Dr. Puneet Madan answered : 12 years ago

Hi,

Your tests are more or less normal but are in a little higher range as for sodium is a little high. Then you also have proteinuria which can have multiple causes like anxiety,blood pressure,diabetes,infection or many others.

Proteinuria can occur due to problems in kidney,and also it can cause other problems in kidney. So you have to remain cautious about this and deal with your blood pressure seriously if that is the only reason or cause for your proteinuria

For now follow the following instructions
1) Lose weight (if overweight), and take regular exercise
2) Stop smoking,and alcohol
3) Reduce the amount of salt in the diet in order to help control the blood pressure,Eat a healthy balanced diet,Drink about 2 litres of fluid a day
4) Consider buying an automatic blood pressure monitor to check the blood pressure at home,and aim at maintaining your b.p at 130/80 and it should never be beyond 140/85.

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