Some Reports From Readers:
Susanne shared this experience:
My physician took me off Lopressor all at once and increased my losartan to 50 mg twice a day. Was this the correct thing to do? I had to go to ER with rapid heart beat and high blood pressure.
We would say that was not the right thing to do!
My family doctor recently told me to stop taking my beta blockers and without consulting my cardiologist. Today I went for a bike ride. Now I have a very heavy feeling in my chest and it is causing a lot of pain. Could this be caused by going off my beta blocker?
We advised Josie to call her doctor immediately and have this checked out!
Peppy offered this scary experience:
My doctor had me taper off metoprolol over two weeks. I dont think that was slow enough as I got the worst migraine headache that would not go away plus a rapid heart rate. My blood pressure went up! Scary!
They had a hard time getting that headache stopped. A friend of my sisters had the same headache experience when they stopped her metoprolol.
This stuff is nothing to mess with, from my experience. The doctor told me there is a rebound effect.’
Our Guide to Blood Pressure Treatment has information on the pros and cons of several different kinds of blood pressure medications. You will learn more about the benefits and risks of lisinopril and other ACE inhibitors like benazepril, captopril, enalapril, fosinopril, quinapril and ramipril. It can be downloaded for $2 from our Health Guide section.
With This Background What Should You Do
S You Can Take To Overcome Resistant Hypertension
Dr. Thomas offers eight tips for managing hypertension. If you do these things, youll know youre doing all you can to help:
Managing hypertension isnt always easy, but making these changes is worth the effort. They will go a long way toward reducing your risk of heart disease and stroke.
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Which Raises Two Important Issues
Are doctors overprescribing medication for blood pressure? The answer to that is yes.
Second, has it ever been shown that its okay for someone who for years has had well-controlled high blood pressure to go off their meds and see if the body has reset itself and the high blood pressure is, in fact, gone?
Again, the answer is yes as youll see below.
If youre currently taking a blood pressure medication OR your doctor has remarked that shell be keeping an eye on your borderline high blood pressure OR high blood pressure runs in your family and you have concerns about it, please read this Health Tip closely. The issues surrounding blood pressure are far more complex than you might guess.
Importantly, your doctor, who we can safely assume intends the best for your health, may be basing her recommendations and prescribing on what, unbeknownst to her, is actually some very controversial information. She simply may not be aware that shes starting you on what could be decades of inappropriate medication for a condition you dont really haveand one that isnt even dangerous to your health.
In fact, based on government guidelines in which your doc is paid less by insurance companies for failing to reach certain clinical goals , she may be encouraged to prescribe more meds for your potentially non-existent elevated blood pressure. Read that sentence a couple of times and let it sink in.
What Will It Take
If you are committed to getting off medications safely, it will definitely require major behavioral changes. For each person the pathway may be different. For example, to get off of pain medications may require dramaticweight loss to unweight your back, knees, or hips.
For other conditions, such as anxiety, it may require religiously exercising, meditating, yoga, and volunteering to get to a point where you could safely come off medications. Getting off of sleeping pills may require you to aggressively manage stress and anxiety, stop caffeine after 10 am, exercise outside every day, and religiously go to bed at the same time every night.
In my cardiology practice, most of my patients want to get off of blood thinners. These blood thinners are critical in preventing strokes. For some of these patients, the only pathway off of blood thinners may require them to completely reversetheir diabetes or high blood pressure.
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Weaning Off Blood Pressure Medication
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!
HealthTap doctors are based in the U.S., board certified, and available by text or video.
What You Need To Know
- Twenty percent of patients with hypertension are resistant.
- Resistant hypertension may have no symptoms at all for months or years, but then can cause heart attack, stroke, and vision and kidney damage.
- Some people have pseudoresistant hypertension, which is caused by other factors, such as conflicting medications or white coat hypertension .
- Pseudoresistant hypertension is important to diagnose and treat.
- Assessment and treatment of resistant hypertension includes addressing any identifiable conditions or causes and adjusting medications in a personalized way.
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Make Lifestyle Changes First
Even if you don’t have high blood pressure, it’s important to take steps to keep it under control because it tends to get higher with age. That’s especially important if you’re a black American or have a family history of the condition, since both sharply increase the risk of developing it. And a healthy diet and lifestyle are essential if you already have high-normal readings. For people with high blood pressure, lifestyle measures can sometimes reduce or even eliminate the need for drugs. For example, research has found that the DASH diet can be as effective as medication for some people with mild hypertension. This relatively low-sodium diet relies on fruit, vegetables, and low-fat dairy products. The potassium in those foods, and possibly the calcium, too, appear to help control blood pressure. For people with normal blood pressure and no heart disease or stroke risk factors, the suggested 2,400 mg daily sodium limit, achievable by adopting the DASH diet alone, might help ward off the upward creep of blood pressure that can occur with age. Other steps include losing excess weight, exercising regularly, and drinking alcohol only in moderation, as shown in the table below.
|Aim for a body mass index under 25.||2.5 to 10 mmHg for about every 11 pounds|
Taking High Blood Pressure Drugs Properly
If you’re like most people with high blood pressure, drugs are a major part of your plan to lower your blood pressure. Your doctor’s goal is to find the right combination of high blood pressure medicines that accomplishes these goals:
- Lowers your high blood pressure to normal levels
- Is easy to take
- Has few or no side effects
How can you work with your doctor to make sure your high blood pressure medicine is meeting these goals? Perhaps these 10 tips can help.
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Monitor Your Blood Pressure At Home
Its important to get your blood pressure under control with medications first if youve been diagnosed with high blood pressure. Then, make sure youre watching your numbers closely with a home monitor. This is because losing weight, cutting back on sodium, and exercise alone can change your blood pressure within a few weeks.
The Medication Snowball Effect
In Marks case, one simple statin soon led to two more medications. Indeed, this happens far too often. Is it any wonder that 20% of all Americans take five or more medications?
In the medical field we call this polypharmacy. The more medications you take the more symptoms you have. Soon you are taking medications to counter the symptoms of the other medications. It is hard to safely break free of this cycle.
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Can You Get Off Of High Blood Pressure Meds If You Lose Weight
High blood pressure, also called hypertension, increases the risk of heart attack, kidney disease and stroke. The right medications can help lower blood pressure and prevent long-term complications. Medications are more effective when paired with healthy lifestyle changes, such as following a low-sodium diet and exercising regularly. If you’re overweight, weight loss may allow your health care provider to lower the dosage of your medication or you may be able to stop taking it.
One: What Exactly Is Normal Blood Pressure
This simple question is actually fraught with controversy, backbiting, scandal, and truly egregious self-serving behavior on the part of highly placedand highly paidphysicians, drug companies, and apparently neutral organizations like the Food and Drug Administration and the World Health Organization . For an idea of how the answer to this question has shifted, if you have some spare time take a look at this piece, which examines the scope of change in high blood pressure treatment over the course of a decade.
If you remember what I wrote about statins and high cholesterolthat lowering the number for ideal cholesterol meant an increase of multiple millions of statin usersprecisely the same sequence of events has occurred with high blood pressure meds.
Over the years there have been numerous studies, all but one financially supported by the pharmaceutical industry, to determine a risk-free blood pressure number. When I was first in training, I learned that blood pressure levels normally rose with a persons age. The magic formula we were taught? The systolic reading was 100 plus your age. The bottom number should be 90 or lower.
Thus, a healthy blood pressure for a 50-year-old could be 150/90. Basically, you started treatment when someones blood pressure was 160/100 or higher. I remember one professor saying he preferred 160/95.
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Remember To Refill Your Prescriptions
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High blood pressure drugs need to be taken on schedule. So don’t let your supply run out! This can be tricky, especially if you use multiple drugs and different pharmacies. See if any of these suggestions might help:
- Find out exactly how soon you can reorder your prescription. Usually it’s about a week before your current supply runs out. Insurance companies have different rules for how early you can request a refill before the current supply runs out.
- Try to use only one pharmacy. It will be easier to talk to a pharmacist about possible drug interactions among prescription and nonprescription drugs and supplements and make sure you are not taking duplicate medicines.
- Use a friend or family member to help you find your way through the insurance, mail order, or other groups you must deal with in order to get your refills.
- If you’re planning to travel, have all of your medication ready to go with you. Keep it with you, rather than in your checked baggage when flying.
When Treatment Is Recommended
Everyone with high blood pressure is advised to make healthy lifestyle changes.
Whether medicine is also recommended depends on your blood pressure reading and your risk of developing problems such as heart attacks or strokes.
Your doctor will carry out some blood and urine tests, and ask questions about your health to determine your risk of other problems:
- if your blood pressure is consistently above 140/90mmHg , but your risk of other problems is low you’ll be advised to make some changes to your lifestyle
- if your blood pressure is consistently above 140/90mmHg and your risk of other problems is high you’ll be offered medicine to lower your blood pressure, in addition to lifestyle changes
- if your blood pressure is consistently above 160/100mmHg you’ll be offered medicine to lower your blood pressure, in addition to lifestyle changes
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Can I Stop My Hypertension Medication
To make an informed choice about your need for ongoing treatment, you and your healthcare provider will first need to review the cause of your high blood pressure.
- Family history of high blood pressure
- Lack of exercise
- Too much salt in your diet
The factors that contribute to high blood pressure generally fall into two categories: modifiable and unmodifiable.
Modifiable factors are those you can make changes to, such as your diet and activity level. Others, like genetics and age, are not factors you can control.
In 90-95% of cases, the exact cause of hypertension is never found. This type of high blood pressure is called “essential hypertension” or “primary hypertension.”
If your healthcare provider determines that your high blood pressure is primarily related to modifiable factors and your blood pressure readings normalize after you make changes, it may be time to discuss whether you need to continue taking medication.
Research has yet to establish exactly how long patients need to have normal blood pressure after making lifestyle changes before stopping meds, but several studies have suggested waiting anywhere from six months to two years.
Ultimately, the decision is subjective, and each person’s needs must be assessed individually. However, if you’ve lost weight, sustained a healthy diet and exercise program, and quit smoking, your healthcare provider may decide to have you try a trial period without medication.
Know The Possible Side Effects Of Your High Blood Pressure Drugs
Each type of high blood pressure drug has possible side effects. Some side effects may be temporary some may be more lasting. Some side effects are bothersome some may be potentially dangerous. Ask your doctor or pharmacist these questions about each of your medications:
- What side effects might occur? Which are common and which are rare?
- What should I do if I notice side effects?
- Are there medicines, food, or beverages that can interact with this drug?
- What are serious side effects that I need to be aware of?
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My Take On Normal Blood Pressure
So whats normal? Most doctors agree it depends on the individuals situation.
Lets call 145/95 borderline high blood pressure.
If there are no other risk factors , I begin treatment at this point or higher with a low-salt Mediterranean/ketogenic diet and stress reduction, including yoga, tai chi, or meditation. If there are risk factors such as those noted above, Ill prescribe a medication and discuss the lifestyle changes outlined below.
Very high blood pressures, like 160/110 or higher, do require prompt pharmacological intervention.
Don’t Rely On Supplements
While a diet rich in potassium and possibly calcium can help control blood pressure, it’s unclear if supplements have the same effect. And some recent research suggests that too much calcium from supplements might increase the risk of heart disease and other health problems.
As for potassium, the form in supplements might not have the same effect as the kind in foods. And too much of it, even from food, can cause problems for people with heart failure or kidney disease, and for those who take certain blood pressure drugs, including ACE inhibitors, angiotensin receptor blockers, and potassium-sparing diuretics such as spironolactone . So talk with a doctor before increasing your intake.
If you take diuretics, your doctor may prescribe a potassium supplement, because those medicines can lower potassium levels.
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Getting Off Blood Pressure Meds
Health Tips / Getting Off Blood Pressure Meds
If youre currently taking a blood pressure medication OR your doctor has remarked that shell be keeping an eye on your borderline high blood pressure OR high blood pressure runs in your family and you have concerns about it, please read this Health Tip closely. The issues surrounding blood pressure are far more complicated than you might guess.
Importantly, your doctor, who we can safely assume intends the best for your health, may be basing her recommendations and prescribing your medication on what she may not know is actually some very controversial information. She simply may not be aware that shes starting you on what could be decades of inappropriate medication for a condition you dont really haveand one that isnt even dangerous to your health.
In fact, based on new government guidelines in which your doc is paid less by insurance companies for failing to reach certain clinical goals , she may be encouraged to prescribe more meds for your potentially non-existent elevated blood pressure. Read that sentence a couple of times and let it sink in. It means if your blood pressure is not at a particular normal level AND your doctor has failed to give you medication to reach that level, she can be financially penalized, even if your actual blood pressure level is totally harmless to your health. Tell me thats not just a little bit spooky.