What if my blood pressure just won’t go down?

Published: Monday, December 11, 2023

If you’ve been diagnosed with high blood pressure, the odds are that your provider recommended some lifestyle changes or prescribed medication to help lower it. What happens if your blood pressure doesn’t respond to treatment?

For most people, basic treatments like medications and lifestyle changes are enough to lower blood pressure into a healthier range. Sometimes, you’ll need to experiment with a few types of medication before finding the one that works best for you.

In some cases, though, high blood pressure is persistent and not responsive to medications. This is what’s known as resistant hypertension.

If you are diagnosed with resistant hypertension, don’t let worry overwhelm you. Specialized treatment is available through the Resistant Hypertension Center at Georgia Heart Institute.

Why is high blood pressure dangerous?

To understand high blood pressure, let’s first define blood pressure. Blood pressure is the force with which blood flows through the blood vessels as it moves through the body.

When your blood pressure is normal, blood courses through those blood vessels seamlessly, carrying essential nutrients and oxygen. When your blood pressure is high, blood is stretching the blood vessel walls quite forcefully.

The force and the friction of that pressure can damage the blood vessel walls over time, which can lead to atherosclerosis, the buildup of fatty plaque in the arteries that can eventually block blood flow. This increases your risk of serious health issues, including heart attack, stroke, heart rhythm disorders, heart failure, kidney disease, and even vision loss.

What can be done to lower blood pressure?

First-line treatment for lowering blood pressure often includes lifestyle changes. Many lifestyle-related factors increase the risk of high blood pressure, so changing your habits can often positively impact your blood pressure.

Eating a balanced diet low in salt and saturated fat, exercising regularly, maintaining a healthy weight, limiting stress, getting enough quality sleep, and not smoking are good steps in the right direction toward a healthy blood pressure level.

When lifestyle changes alone aren’t enough, antihypertensive medications may be prescribed to help lower blood pressure. Different types of medications help lower blood pressure in different ways.

Medications known as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), for example, work to keep blood vessels from narrowing, while diuretics reduce the amount of fluid in your blood. Beta-blockers cause your heart to beat slower, and calcium channel blockers allow the blood vessels to relax.

While some experimenting may be necessary to find the right medication or combination of medications, sometimes blood pressure stays high despite intervention. Someone who continues to have high blood pressure despite taking three antihypertensive medications, including a diuretic, is considered to have resistant hypertension.

If you’re diagnosed with resistant hypertension and referred to the Resistant Hypertension Center, a specialized team of providers will work with you to monitor your health and determine an appropriate treatment plan. Because underlying factors often contribute to high blood pressure, step one will be recording and deciphering any patterns in your blood pressure levels.

From there, your doctor will look for factors that can impact blood pressure, such as sleep disorders, hormonal abnormalities, and vascular conditions like renal artery stenosis. Once it’s determined whether you have primary resistant hypertension (with no underlying cause) or secondary resistant hypertension, you will receive a treatment plan that’s personalized for your needs and evolves over time.

If another medical condition is an underlying factor contributing to your high blood pressure, our expert providers will work alongside other medical specialists to help effectively treat your condition. Your treatment plan will include both lifestyle recommendations and medications.

Learn more

If your blood pressure just won’t go down, you may have what’s known as resistant hypertension. The Resistant Hypertension Center at Georgia Heart Institute offers specialized therapies that can help.