Blood pressure is always 'over the threshold', why can't medication lower it?

Blood pressure is always high, taking medicine does not lower it

Recently, Dr. Doan Du Manh, a member of the Vietnam Vascular Disease Association, received and treated a female patient (37 years old, in Hai Phong ).

The patient said that in recent years, his weight increased rapidly and his blood pressure was often very high, fluctuating around 180mmHg (normal blood pressure is on average 110 to 120mmHg).

The patient visited many medical facilities and was prescribed daily blood pressure medication. However, her blood pressure remained unstable, forcing her to maintain long-term treatment.

Recently, the patient planned to undergo in vitro fertilization (IVF) and was asked by the doctor to adjust his blood pressure to a safe level before proceeding.

During the pre-IVF examination, Dr. Manh noticed that the patient was quite young but had severe and prolonged high blood pressure, so he advised the patient to undergo in-depth examination to find the root cause.

The results of the in-depth examination, computed tomography (CT) scan using photon technology, discovered that the patient had a benign tumor (adenoma) in the right adrenal gland. This type of tumor has the ability to secrete the hormone aldosterone or cortisol, causing salt and water retention, increasing blood volume and increasing blood pressure.

When he received the diagnosis of high blood pressure due to an adrenal tumor, the patient was very surprised.

According to Dr. Manh, people who develop high blood pressure at a young age, have difficult to control blood pressure, or have signs of electrolyte disturbances should be aware of the cause of adrenal tumors.

Early detection and treatment of adrenal tumors not only helps control blood pressure effectively, reduce the risk of cardiovascular complications and stroke, but also improves quality of life, especially for those who want to reproduce.

The patient is currently being advised on a treatment plan for the adrenal gland tumor, to bring blood pressure to a safe level before continuing the IVF plan.

Why does adrenal gland tumor cause high blood pressure?

Dr. Manh said that adrenal tumors secrete aldosterone (also known as primary aldosteronism - PA) and cortisol. Aldosterone encourages the body to retain sodium and water, increasing blood volume, leading to high blood pressure.

Cortisol increases heart rate and constricts blood vessels, contributing to high blood pressure. In some cases, pheochromocytoma also secretes catecholamines, causing persistent high blood pressure or hypertensive crises, which may be accompanied by headaches, palpitations, and sweating.

According to Dr. Manh, although adrenal tumors are usually benign, if not detected and treated promptly, prolonged high blood pressure will increase the risk of stroke, heart failure or kidney damage.

Young people with poorly controlled hypertension and hypokalemia should be screened for adrenal causes.

Dr. Manh said that adrenal tumors are one of the common causes of high blood pressure. However, the disease can be completely cured if the patient detects it early and has the tumor removed.

Currently, computed tomography (CT) or magnetic resonance imaging (MRI) are effective methods to detect adrenal tumors. Depending on the type of tumor and the level of hormone secretion, the doctor may prescribe medical treatment or surgery to remove the tumor, helping blood pressure return to normal levels.

The cardiologist also recommends that if unexplained high blood pressure occurs, people should see a specialist for diagnosis. Uncontrolled high blood pressure can increase the risk of stroke and other cardiovascular problems.