What should I do if I can't lower my high blood pressure with medication

The inability to lower high blood pressure with medication may be related to improper medication selection, unadjusted lifestyle, or the presence of secondary hypertension. Need to re evaluate medication regimen, improve lifestyle habits, and conduct targeted examinations.

1. Improper drug selection. There are many types of hypertension drugs, and their applicability varies greatly among different patients. Common antihypertensive drugs include calcium channel blockers such as amlodipine and nifedipine, angiotensin-converting enzyme inhibitors such as enalapril and benazepril, diuretics such as hydrochlorothiazide and furosemide. If the current medication is not effective, the medication plan should be adjusted under the guidance of a doctor, which may require combination therapy or changing the type of medication.

2. Lifestyle not adjusted. Relying solely on medication and neglecting lifestyle improvements may lead to unsatisfactory blood pressure lowering effects. It is recommended to control the daily salt intake to below 5 grams and increase the intake of potassium rich foods such as bananas and spinach. Maintain regular exercise and engage in 150 minutes of moderate intensity aerobic exercise per week, such as brisk walking and swimming. At the same time, quit smoking and limit alcohol consumption, ensure sufficient sleep, and reduce mental stress.

3. Secondary hypertension. Some patients may have secondary hypertension factors such as kidney disease and endocrine disorders, leading to poor drug efficacy. Relevant examinations are required, such as kidney function testing, adrenal CT, thyroid function examination, etc. If secondary causes are found, treatment should be targeted at the primary disease. For example, renal artery stenosis can be improved through angioplasty, and primary aldosteronism can be treated with drugs such as spironolactone.

4. Medication compliance issues. Some patients may not take their medication on time due to drug side effects or economic reasons, which may affect their blood pressure lowering effect. It is recommended to communicate with a doctor and choose drugs with fewer side effects, or to reduce the economic burden through medical insurance policies. Use smart medication boxes or mobile reminder functions to improve medication adherence.

5. Inaccurate blood pressure monitoring. Improper methods of self testing blood pressure at home or calibration issues with blood pressure monitors may result in measurement bias. It is recommended to use a certified upper arm electronic blood pressure monitor, sit quietly for 5 minutes before measurement, maintain the correct posture, and take the average of 3 consecutive measurements. Regularly calibrate the blood pressure monitor to ensure accurate measurement results.

If high blood pressure cannot be lowered with medication, a comprehensive evaluation of medication, lifestyle, and potential disease factors is needed. Adjust medication plans under the guidance of doctors, adhere to a healthy lifestyle, conduct targeted examinations, and pay attention to improving medication compliance and blood pressure monitoring accuracy. Only through a multi pronged approach can blood pressure be effectively controlled and the risk of cardiovascular and cerebrovascular diseases be reduced. Regular follow-up visits and timely adjustment of treatment plans are key to long-term management of hypertension.