Mixture of Medicines Might Be Too Much

Q. High blood pressure runs in my family. Both my parents had hypertension. Despite following a low salt diet and exercising, my blood pressure crept up.
When my systolic number hit 160, my doctor prescribed medicine. First he gave me hydrochlorothiazide, then metoprolol, and finally added amlodipine, lisinopril and Diovan.
My blood pressure is now around 110/70, and my doctor is happy. I am always tired and dizzy. I am so short of breath I can no longer exercise as I used to. My ankles are swollen and my pulse rarely gets above 50. Could my blood pressure be too low?
A. The five blood pressure medications you are taking could easily be causing your symptoms. A new study found that overtreatment of hypertension is common (Archives of Internal Medicine, online, May 28, 2012). When diastolic blood pressure goes too low, people are at greater risk for heart problems.
Metoprolol might be causing your slow heart rate and shortness of breath, while amlodipine can lead to swollen ankles and dizziness.
We are sending you our Guide to Blood Pressure Treatment with more details on the side effects of all your medicine and some non-drug approaches to controlling hypertension. Combining drugs like lisinopril and Diovan is controversial and may pose unexpected risks (European Heart Journal, Sept., 2010).