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You are quite correct to be worried about your high blood pressure and the evntual risks of a heart attack and/or stroke.
At first look it appears that you have indeed "Resistant Hypertension", assuming you are taking all your medications and live a heart healthy life style and that anatomic abnormalities such as coarctation have been excluded (very likely by now).
However, any treatment of hypertension involves optimizing the things you can do, and for your doctor to make sure the following issues are taken care of:
The tests are done to make sure you don't produce abnormal levels of hormones and that your BP is always too high:
- VMA urine testing is done to check whether you produce abnormal levels of adrenaline etc. The test is usually done to diagnose an adrenal gland tumor called pheochromocytoma that can be cause of severe hypertension.
- Plasma ACTH levels are done to see if you produce too much cortisol.
- Ambulatory blood pressure monitoring (ABPM) is done by means of a device that is worn for either 24 or 48 hours and done to confirm your BP is indeed too high, and if so, when and possibly why.
From what you have written, it is not unlikely all the blood/urine tests will return as normal and you will continue to have stage II hypertension (BP>160).
Thus, here some recommendations:
Your doctor should consider changing to a different medication routine if it appears the present treatment has been optimized (In many cases the choice of agent isn’t as important as using whatever regimen works to attain the goal blood pressure, as tolerated).
There are studies that have tested the effectiveness of "renal denervation" in patients like you. You may be a candidate for this procedure if all the other recommendations fail to improve your situation.
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