Dear Fixit,

You are on combination therapy for what must be quite resistant hypertension. The Carloc is both a beta and an alpha blocker, and the Micardis is an A.C.E. receptor blocker.

In a small percentage of hypertensives, there is a detectable, and thus treatable, cause.(eg a hormone secreting tumour, adrenal dysfunction). In the vast majority, though, the diagnosis of “essential” hypertension is made: that means we don’t know why it occurs. So, all we can do is to take steps to prevent the BP rising too high, and thereby hope to avoid the complications of untreated hypertension(heart attack, stroke, sudden death). In these – the majority – the aim of treatment is to prevent the arteries “tightening up” or going into spasm. As the arterial wall is largely made of muscle, any substance causing this muscle to relax will allow the vessel to dilate, and thereby drop the pressure within. This is a simplistic explanation, but I’m sure you get the idea. Why the arterial wall should be so tense is the riddle of essential hypertension, but relaxing it does bring the pressure down. The medication you are on, works by blocking receptors on the arterial wall, thus preventing the artery from tightening up and raising BP.

You have the gist of the numbers. The upper number –the systolic – represents the pressure within the artery during contraction or pumping of the heart. The higher the number, the harder the heart has to pump to get blood circulating in the body. Hence the increased workload on the heart in hypertension. The lower number – diastolic – can be seen as the “resting tension” in the artery wall during the relaxation, or filling phase of the heartbeats. This number is significant because it represents the constant, background tension in the artery.

I hope this answers your questions.

Heartdoc