DEAR DR. GOTT: I’m having a terrible time controlling my blood pressure. I have been on many medications but none help. My systolic is in the 180 to 200 range most of the time and always very high when I get up in the morning.
My local doctor is at a loss as to what to do next. He sent me to a cardiologist and to a kidney specialist. (My heart and kidneys are fine). I also had a Doppler study on my kidneys and carotid artery and an ultrasound on my kidneys. Those results were good.
I’m a 68-year-old white female, retired. I walk 30 minutes every day and have been a diabetic for 20 years. I have glaucoma, esophageal reflux disease and neuropathy in my feet from the diabetes. My doctor prescribed clonidine patches but I don’t feel comfortable using them because of the aluminum that’s in them that goes into my body continuously. He said they would be used for the rest of my life. What do you think about them? My pulse is in the 40s and 50s. Could the clonidine be causing that?
My brother has this same blood pressure problem. Could it be inherited? I’m really concerned about having a stroke and need help badly.
I weigh 182 pounds and stand 5’2 ½’ tall. I can’t lose weight as long as I take insulin because it stores fat, so my doctor tells me. Do you agree? I tend not to, since there are a lot of slim diabetics out there. My meds are Novolog, regular insulin, clonidine HCL, HCTZ, Nexium, Lumigan eye drops for glaucoma and aspirin for pain. I live alone, my children are grown. The only time I feel depressed is when I think about my weight and the high blood pressure.
I will eagerly await a reply from you.
DEAR READER: Your clonidine patch was prescribed to lower your uncontrolled blood pressure. A single patch provides continuous systemic delivery of clonidine for seven days at a consistent dosage. The three-layered system has a backing layer of pigmented polyethylene and polyester film; followed by a solid matrix reservoir of clonidine, mineral oil, polyisobutylene and colloidal silicon dioxide; and an adhesive formula of the four previously mentioned components. One of this product’s inactive ingredients is #10 aluminum lake and FDC yellow #6 aluminum lake. You are likely uncomfortable taking this because of evidence that shows the brains of Alzheimer’s sufferers contain alumnium deposits. To the best of my knowledge, no evidence has been found that suggests aluminum in the patch increases the risk of Alzheimer’s or causes it; therefore, I believe it is safe for you to take without worry.
If side effects occur, they are considered mild and tend to diminish with continued therapy but hypotension and sinus bradycardia have been reported which could explain your low pulse rate. A three-month controlled clinical trial of 101 patients revealed dry mouth in 25 of the patients, drowsiness in 12, fatigue in 6, headache in 5, sedation and lethargy in 3. More than 50% had localized skin reactions such as burning, excoriation, erythema and rash, particularly following the adhesive cover throughout the 7 day patch usage. In another substantially larger study, contact dermatitis was so dramatic in about 20% of users, treatment was discontinued.
Nexium, on the other hand, causes a rapid heart beat in some patients. Here I must wonder what happens when one medication causes a slowed rate, while another taken causes a rapid beat. In my experience, less medication is better and because you are taking Nexium for occasional gastroesophageal reflux disease, you might consider either discontinuing it or switching to another remedy.
You are correct that the NovoLog you have been prescribed is known to cause weight gain and is possibly why you are having problems controlling your weight. This brings up a very important point. The issues you are having appear directly related to the medications you have been prescribed. You don’t appear to be doing anything wrong. Speak with your prescribing physician(s) about your concerns and ask if a medication change, different exercise regimen, visit with a dietician, or something else might be appropriate for overall control.
There are a number of conditions that cause hypertension, to include age, gender, race and a family history. So yes, for some, hypertension is hereditary, sometimes making it extremely difficult to control. Risk factors such as obesity, too much salt in the diet, cigarette smoking, inactivity and stress can contribute to the issue but can be controlled.
Readers who would like related information can order my Health Report “Hypertension” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at P. O. Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
