High Blood Pressure That's Hard to Treat

What happens if your blood pressure isn't going down?

You’ve made lifestyle changes. You’re taking several blood pressure medications. But your blood pressure still isn’t going down. This is called resistant hypertension. This means your high blood pressure is hard to treat and may also have another cause. 

Possible causes

Resistant hypertension may be caused by one or more medical conditions. Health care professionals typically look for possible causes such as:

  • Problems with hormones that control blood pressure
  • Plaque in the blood vessels that feed the kidneys
  • Sleep problems, such as sleep apnea
  • Obesity
  • Heavy use of alcohol
  • Prescription or nonprescription medications that can elevate blood pressure

Monitoring and treatment 

Controlling blood pressure begins with the basics, such as understanding your blood pressure patterns. That might mean:

  • Wearing a small automatic blood pressure recorder for 24 hours
  • Checking pressure with an at-home monitor several times a day

Treatment might also include:

It is important to take the right medications in the right doses at the right time. Do not take medications or supplements that can increase blood pressure such as:

  • Diet pills and stimulants
  • Cyclosporine or Tacrolimus (drugs used to prevent organ rejection after a transplant)
  • Natural licorice
  • Herbal agents such as ma huang or Ephedra
  • Non-steroidal anti-inflammatory drugs such as ibuprofen and celecoxib
  • Antacids containing sodium
  • Caffeine
  • Birth control pills
  • Decongestants

Ask your heath care professional or pharmacist if any medications you take could be increasing your blood pressure.

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