What happens if through lifestyle changes you lower your blood pressure significantly yet you are still on blood pressure medication from years past?
In short, it’s not always an easy answer.
To make an informed choice about your need for ongoing treatment, you and your BIMC doctor will first need to review the cause (or causes) of your high blood pressure. They may include:
- Being overweight or obese
- Lack of exercise
- Too much salt in your diet
- Excessive alcohol intake
- Older age
- Family history of high blood pressure
- Chronic kidney disease
- Thyroid disorders
- Sleep apnea
While there may be many other contributing causes, what this short list illustrates is that some risk factors are modifiable (such as diet and exercise) and others aren’t (such as genetics and age).
If the cause of your high blood pressure is primarily related to modifiable factors and you’ve achieved normalized blood pressure readings, then there may be a reasonable cause to stop treatment.
With that being said, there is nothing in the way of research to suggest how long you would need to have normal readings before the decision is made.
Six months? A year? Two years? In the end, the decision is highly subjective with no cut-and-dry answers. Each case is unique and needs to be assessed individually.
However, from a broad perspective, if you have lost significant weight, have sustained a healthy diet and exercise program, and have confidently stopped smoking, then it may be reasonable to see how things go.
If you stop and your numbers go up, then you at least have the option to get back on treatment and set things right.
When Stopping May Be Inappropriate
If your high blood pressure is related to non-modifiable factors such as family history or variable ones such as a chronic disease, then stopping treatment may be less appropriate. This is especially true if you are older since age is not only an independent risk factor for hypertension, it tends to be associated with greater complexities in managing chronic illness.
Even if you are able to lose weight, stop smoking, and exercise regularly, a drop in blood pressure may not sufficient enough to warrant a change in treatment. Even the slightest elevation above normal would not justify the change, especially now that the revised universal guidelines have lowered the normal blood pressure threshold from 140/90 mm Hg to 130/80.
It is also important to note that, in as many as 90 percent of cases, the exact cause of hypertension will never be found. This type of high blood pressure is called “essential hypertension.”
Given these figures, making the call to stop treatment is something you should never take lightly.
What This Tells Us
Ultimately, the reason to lose weight and make better lifestyle choices is not to avoid taking drugs. It’s about living healthier and improving the quality and duration of your life.
If you believe that you’re healthy enough to stop treatment but your doctor advises against it, try to listen as closely as possible to his or her reasons. You are not being punished, and the recommendation doesn’t mean that you are in “poor” health. It is simply that the benefits of treatment may outweigh the possible consequences of stopping.
Despite the aversion some people have to pharmaceutical medications, there is nothing inherently “bad” about taking antihypertensive drugs. They are not addictive, side effects are relatively manageable, and their use is associated with a longer life and better health irrespective of the disease stage.
The one thing you should never do is stop treatment on your own. It can be damaging to your health, particularly since you will be less likely to seek regular medical care. If you don’t agree with your doctor, do yourself a favor and get a second opinion.
Feel free to make a choice, but make sure it’s an informed one with you and your BIMC doctor.