DEAR DR. DONOHUE: I've had severe high blood pressure for many years. I have tried all the medicines you can think of. I am 62 and have had one ministroke. I'm not looking for another. I used to weigh 235 pounds. I lost 100 pounds. I watch my salt. I have tried everything. My family has a history of high blood pressure. Can you recommend anything? -- F.
ANSWER: Blood pressure that doesn't drop by making life changes (weight loss and diet) or by taking three or four blood pressure medicines is called resistant high blood pressure (hypertension). Your weight loss is admirable. It should have reduced your pressure.
Watching your salt intake is also important. That entails more than not using the salt shaker. It requires you to carefully look for the salt content (listed as sodium or sodium chloride) of all your foods. Commercial soups, frozen dinners, many canned goods and luncheon meats often have a high salt content. Your diet should be one of fruits, vegetables, whole grains (unrefined wheat, barley, rye and oats) and one where meat and fats are eaten sparingly.
Increase foods with lots of potassium in them: tomatoes, potatoes, prunes, lima beans, kidney beans, navy beans, bananas, oranges and orange juice, spinach, peaches, cantaloupe and broccoli. Potassium lowers blood pressure.
Exercise for 30 minutes every day. Get your doctor's approval first, and start out modestly. Brisk walking is fine.
For resistant high blood pressure, your doctor has to look for the less-common causes of it. Sleep apnea (loud snoring with pauses when there is no breathing), adrenal gland tumors, Cushing's syndrome, narrowed kidney arteries and rare tumors such as pheochromocytoma are cases in point.
Go over your medicines. Some medicines raise pressure. Nonsteroidal anti-inflammatory drugs are an example -- Aleve, Advil, Motrin, aspirin and other NSAIDs. Don't drink more than two alcohol drinks a day.
More than 30 blood pressure medicines are on the market. I bet you haven't tried all 30 or combinations of them. Some brands come with two medicines in one pill, easing the burden of pill-taking. A new medicine, one completely different from all other medicines, is now available. It is Tekturna. Something must be done for your pressure.
The booklet on high blood pressure gives the story of this very common malady. To receive a copy, write: Dr. Donohue -- No. 104W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Allow four weeks for delivery.