Whast is the reason or reasons for being unable to control pressure with drugs?

High BP Control: Some times it is difficult to control bp, with one, two, three or four medicines with the maximum doses.You have to look for conditions like renal artery stenosis and make sure the patient is complying with the treatment.If patient is taking the medicines and other tests including electrolytes, renal scan are normal and patient is on dash diet and exercise, we use old drugs like Aldomet (methyldopate) and minoxidil.

Difficult problem: The usual culprits are: renal disease, BP drugs being counteracted by other drugs (nsaids for arthritis or use of steroids are common examples), inadequate doses, not enough diuretic. Rarer causes are aldosterone secreting adenomas or adrenal hyperplasia, pheochromocytoma, cushing's disease, renal artery stenosis. It's not unusual for resistant hypertension to require 5 drugs for control.

ETOH, sleep apnea: For stubborn hypertension (high blood pressure) these are other common problems include: non-complicance with meds (patients are just afraid to take too many pills), alcoholism, and untreated/undiagnosed sleep apnea.