On 5 bp meds, why hasn't my blood pressure dropped after the addition of a sixth (Lasix)?

Roxy,

Thanks for your question. 

Your doctor added the small dose of Lasix to help reduce the edema which is a build-up of fluid in the soft tissues, most noticeable in the legs.  If the lasix is working, the fluid should decrease.  This may not necessarily affect your blood pressure because this fluid is outside of your vascular system.  As the lasix reduces the salt and water content in the vascular system, it pulls fluid from the tissues, with net amount of fluid unchanged in your blood vessels.  When there is no extra fluid in the tissues, then the blood pressure may drop because the volume in the vascular system drops.

I am curious why you are on two other diuretics, and now require a third.  Some blood pressure medications cause edema as a side effect.  Rather than add another medication, doctors often change the blood pressure medication, to minimize the amount of medication for the patient.  It might be time to sit down with your physician to go over all your medications, their indication and side effects, and see if he/she can streamline your regimen.  Hopefully, he/she will be open to this.  If not, it may be time for another opinion.

The positive aspect of your situation is that your pressure is normal. 

Feel better. 

Martin Cane, M.D.

Hello,

thank you very much for taking the time to answer my question.

To clarify, the extra diuretic was a shot in the dark and not expected to work. It has not, by the way. For almost three weeks now, I have had considerable abdominal swelling (in addition to my regular peripheral edema). My doctor's initial impression was that the swelling was not from fluid retention. To help rule it out, he added the diuretic. I have just had some tests done today and am awaiting the results.

I have an internist review my drug regimen often. Though reluctantly, other doctors occassionally make changes to it. I have severe hypertension with resulting organ damage. The hypertension had remained uncontrolled for years. Thus the damage. I  believe a drug review is long overdue, and appreciate you reminding me. 

Thank you once again for your answer and for solving this puzzle. I try to keep myself well informed about my medical issues. I know things usually happen for a reason, and, like any three-year-old, I always like to know WHY.   

Roxy