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Blood pressure - 6 tablets daily now - elevated renin levels -

I am slowly starting to despair and my primary care physician can't really offer me proper help at the moment. I only have an appointment with the internist (who is also a cardiologist and nephrologist) in December :(

For about 10 weeks now, my blood pressure has been more or less tinkered with. I am 37 and have been suffering from high blood pressure since pregnancy, in which I developed preeclampsia (values were at 170/115).

I was then prescribed ACE inhibitors (enalapril comp 10/25 dosage 1-0-0 and enalapril 10 dosage 0-0-1).

In March, I went to the cardiologist because I had multiple ectopic heartbeats and my heart was racing for several seconds at a time. Kidney ultrasound, kidney ultrasound all okay.... Blood pressure was nicely elevated (160/98) but it was assumed that it was only due to the "white coat syndrome" and stress at the doctor's office, and I was prescribed Ramipril Comp 5/25 dosage 1-0-0 to be taken only once daily.

I didn't measure my blood pressure again until about 10 weeks ago when I measured values of 178/117.
I thought the Ramipril wasn't working and the primary care physician then prescribed me an additional 5mg of Ramipril in the evening.

The values did not change, they remained high. My regular doctor said, oh, it will be fine... but I switched doctors for the time being.

This new doctor then prescribed me Nefidim in the morning - after a waiting period of 1 week, an additional dose in the evening.

Hardly any change. So then Moxonidine was added - 1 in the morning.
The systolic value then dropped from average values of 170 to 145, diastolic still reaching peak values of 105. So then a special diuretic was added - the result? No change.

A blood test (lying down 30 minutes beforehand) showed a renin value of 67 and now I am supposed to additionally take a beta blocker in the morning, as my pulse sometimes goes up to 115.

I am despairing... how can it be that suddenly my blood pressure is rising so much and even with 6 tablets (I will only start taking the beta blocker tomorrow) it is not controllable. I am slowly not only physically worn out by all the meds, but also psychologically, and now I have to wait another 5 weeks for the appointment with the internist... by then I will probably have completely lost it.

Should I be worried about the renin value and should I wait so long for someone to thoroughly check me out?

Best regards and thank you.

Dr. med. Kathrin Hamann

Hello questioner,

From your description, it seems that you are not making much progress with the diagnostics and the right therapy.

Honestly, I suspect a connection with the blood flow to your kidneys. This fits well with the origin of the issue being related to your pregnancy. I would not wait long for further action, as a consistently high blood pressure in 5 weeks can be very detrimental.

I would recommend a specialist internal medicine clinic that can perform a Doppler of the renal arteries immediately and initiate further examinations of the heart and vascular system.

May I ask where in Germany you are located?

I am happy to assist you further.

Best regards,
Dr. K. Hamann

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Dr. med. Kathrin Hamann

Dr. med. Kathrin Hamann

München

Seit mehr als 20 Jahren bin ich in der Medizin tätig. Als Fachärztin für Allgemeinmedizin helfe ich in meiner Praxis meinen Patienten.

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