Resistant hypertension clinic treating patients when meds fail

Resistant hypertension clinic treating patients when meds fail

High blood pressure is an epidemic in Louisiana and 25 percent of those with hypertension have a resistant form of the disease.  A resistant hypertension clinic at Lake Charles Memorial Hospital's Heart & Vascular Center is treating patients when they do not respond to traditional medications.

Ten years ago, Kathryn Witherwax had her first health scare.  "My head felt like it had a balloon in it," she said, "light-headed and I said, 'Uh oh, something's wrong.'"

Kathryn's blood pressure was over 220, in a hypertensive crisis.  Medications stabilized her, but her blood pressure just would not drop back into a healthy range.  "Mentally it was terrible," she said, "I kept saying I'm going to have a stroke."

Stroke, heart attack and kidney problems can all result from uncontrolled hypertension.  Dr. Peter Angelopoulos is an interventional cardiologist with Memorial Medical Group.  He says lifestyle changes like diet and exercise must happen, along with aggressive medications.  "You can have a whole range of patients that can be controlled on one medication or some people can be controlled with just diet alone," he said, "other patients require a lot more medication and maximum doses of medication."

Kathryn was on the maximum dose of medications before seeing Dr. Angelopoulos last year, seeing little improvement.  About 25 percent of hypertensive patients experience the same resistance.  "Resistant hypertension is defined as a patient taking three or more medications with maximum dosage and blood pressure still greater than 140 over 90," said Dr. Angelopoulos.

Kathryn was prescribed a new medication in combination with another one that had not worked well before, but together, she saw major improvement.  "A week later I came back for a second visit and my blood pressure had already started coming down," she said.

Clinical trials are underway in the United States for a technique being used successfully in Europe and Australia to treat resistant hypertension. It zaps the nerves near the kidneys that fuel high blood pressure.  "They feel that this is what is decreasing the patient's blood pressure and is showing significant hypertension reduction with a three to four year duration," said Dr. Angelopoulos.

That longer term solution is not yet a reality in the U.S., but that is okay with Kathryn, relieved to have success with medication after nine years of worrying.  "I feel really so much better," she said, "I'm not as nervous about stroke and heart damage and kidney damage and everything else that goes along with it."

Patients will undergo an EKG and a series of tests to rule out kidney problems and adrenal tumors before being medicated for resistant hypertension.

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