Secondary Hypertension/rapid heart beat

[napman58]

I am a 50 year old male, who in July was ided as having secondary hypertnesion 230/130.I have
had a heridity hypertension issue since I was 23 which was managed to normal levels with a single
dose (50 mg) of beta blocker Tenormin (Atenolol). Since July I have been placed on the following medication, Norvasc (10mg) daily,Rampiril (20 mg) daily,Atacand (16mg) daily Tiazac (360mg ) daily
Tterazosin (6mg) daily and spironliactone (25 mg) daily as well as 81mg of aspirin and although I
do not have a cholesterol problem I am taking Crestor (10 mg).I have had EKgs, Echo cardiograms,
which have indaicted no blockages although a small valve problem, which has not been considered
to be a root cause of the BP issue.I have also had Doppler imaging of the kidneys which confirm no
renal artery issues and substantial blood work which confirms no adrenal gland issues.Also have
had to wear the 24 BP monitor three times which confirms the BP high throughout a 24 hour period.
Presently with all the medications the BP remains at 190/120.My specialist has indicated that he
feels that stress is a contrbuting factor, as I am employed in a high stress job with a major financial
company and has recommended a short trem disability to determine if being away will cause the BP
to go down.Although I am not adverse to this, I would apprecaite any additional plausable medical
issue that may be root cause. My situation is being closely monitored and I do feel I am getting
good care/treatment,however, I am concerned that this could lead to something bigger ie; a stroke
if I can not get this under control. One of the issues I have also dealt with along with this is a rapid
heart beat and beta blockers were increased to assist with this problem. Given the secondary
hypertension and the heart beat I am somewhat concerned. Could the heart beat issue cause this
BP as opposed to a stress related issue.

[LukeL]

while it is very rare a 24 urine collection to test for a tumor called pheochromocytoma might be the next step. This type of tumor can cause elevated heart rate and BP along with symptoms of panic and anxiety.

[Michael J. McWilliams, M.D.]

The heart beat would not cause the elevated blood pressure.  I would also check a CT or MRI of your aorta to make sure there is not a coarctation.  Regardless of whether you think you are getting good care, if your blood pressure remains that high, it might be worth seeking the second opinion at a tertiary care hospital from someone the specializes in hypertension.  The work up for secondary hypertension is an algorhythm that is pretty easy to look up in a book, but sometimes people that see only one syndrome knows the nuances better.

Short term disability might not be a bad idea just to see if it helps.

I hope this helps.  Thanks for posting.