Hypertension

Uncontrolled high blood pressure is one of the leading drivers of heart attack, stroke, and heart failure — yet it often causes no symptoms until serious damage has already occurred. Arjun Makam, DO, FACC, at Makam Medical specializes in refractory and secondary hypertension: the cases where standard medications haven’t worked, or where an underlying cause hasn’t been identified. Serving patients at our Anaheim and Corona, CA offices, Dr. Makam offers a thorough evaluation to find out why your blood pressure is difficult to control — and a precision plan to fix it. Call us or request an appointment online today.

What is hypertension?

Hypertension — commonly called high blood pressure — occurs when the force of blood pushing against your artery walls is consistently higher than normal. Blood pressure naturally rises and falls throughout the day, but when it stays elevated over time, it quietly damages blood vessel walls, causing them to stiffen and narrow.

This forces your heart to work harder to push blood through your body. Over years, that extra strain significantly increases your risk of heart attack, stroke, congestive heart failure, kidney disease, and vision loss — often without any warning symptoms along the way. That's why hypertension is sometimes called the "silent killer."

What makes some cases of hypertension harder to treat?

Most patients with hypertension respond well to lifestyle changes and one or two medications. But for a meaningful number of patients, blood pressure remains elevated despite multiple medications — a condition called refractory or resistant hypertension. In other cases, high blood pressure is caused by an underlying condition that hasn't been identified, such as kidney artery disease, adrenal gland disorders, obstructive sleep apnea, or thyroid dysfunction. This is called secondary hypertension.

Dr. Makam, DO, FACC, specializes in exactly these cases. If your blood pressure has been difficult to control despite treatment, a specialist evaluation may uncover a treatable cause that has been missed.

What factors affect blood pressure?

Blood pressure is influenced by a combination of factors — some modifiable, some not. Understanding which factors are driving your numbers is essential to building an effective treatment plan. These include:

• Weight and body composition
• Diet, particularly sodium, potassium, and alcohol intake
• Physical activity level
• Smoking
• Chronic stress
• Sleep quality and sleep apnea
• Genetics and family history
• Kidney function
• Other medical conditions such as diabetes, thyroid disease, or adrenal disorders
• Medications and supplements (including over-the-counter NSAIDs and decongestants)

At Makam Medical, we don't just treat the number — we look for the reason behind it.

What can I expect at a hypertension consultation?

Dr. Makam and his team conduct a thorough, patient-centered evaluation. This includes a detailed review of your medical and family history, your current medications and supplements, your diet and lifestyle habits, and any symptoms you've experienced. A physical exam is performed, and diagnostic testing may be ordered to assess heart function, kidney health, and signs of end-organ damage from prolonged elevated blood pressure.

For patients with resistant or secondary hypertension, additional workup may include ambulatory blood pressure monitoring, renal artery imaging, or hormonal evaluation to identify an underlying cause.

What treatments are available for hypertension?

Your treatment plan is individualized based on the specific factors driving your blood pressure. Depending on your situation, this may include:

• Dietary modifications, including a low-sodium, heart-healthy eating plan
• A structured, personalized exercise program
• Weight management support
• Stress reduction and sleep optimization strategies
• Optimized management of contributing conditions such as diabetes, high cholesterol, or sleep apnea
• Medication adjustment or combination therapy
• Evaluation and treatment of an underlying secondary cause

For patients requiring specialty medications or complex regimens, Dr. Makam's dual expertise in cardiology and internal medicine ensures that your blood pressure management is coordinated with your overall cardiovascular health — not managed in isolation.

For expert hypertension care at our Anaheim or Corona, CA offices, call Makam Medical or schedule an appointment online today.