Heart Health High Blood Pressure Living With Once You Start Blood Pressure Medication, Can You Stop? By Craig O. Weber, MD Craig O. Weber, MD Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years. Learn about our editorial process Updated on April 03, 2023 Medically reviewed by Jeffrey S. Lander, MD Medically reviewed by Jeffrey S. Lander, MD LinkedIn Twitter Jeffrey S. Lander, MD, is a board-certified cardiologist and the President and Governor of the American College of Cardiology, New Jersey chapter. Learn about our Medical Expert Board Fact checked by Zerah Isaacs Fact checked by Zerah Isaacs Zerah Isaacs is a technical research assistant with experience in both academic and industry biomedical research. Learn about our editorial process Print Hero Images / Getty Images Table of Contents View All Table of Contents When It May Be Possible to Stop When You Shouldn’t Stop Risks of Stopping Blood Pressure Medication How to Stop Safely Talk About Your Concerns Reasons Stopping May Be Recommended Blood pressure medications are usually taken for life. However, some people are able to stop taking them by addressing the underlying causes of high blood pressure (hypertension) that can be changed. Modifiable risk factors that contribute to hypertension include carrying excess body weight, smoking, drinking too much alcohol, eating salty foods, and having a high-stress life. Lifestyle changes can help you remove these risks and control your blood pressure without medication. But do not stop taking blood pressure medication without discussing it with your health care provider. This article looks at what to consider before stopping hypertension drugs, when you shouldn't go off of them, and how to make the best decision for your health. Hypertension Doctor Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. When It May Be Possible to Stop Whether it's safe to stop your blood pressure medication depends on what's causing your hypertension. The factors that contribute to high blood pressure generally fall into two categories: modifiable and unmodifiable. Modifiable factors are things you can change. Those include: Dietary issues, including too much salt Low activity level Being overweight or obese Excessive alcohol intake Smoking Stress Lifestyle changes that help you to address one or more of these factors may help you control your blood pressure. What Is Normal Blood Pressure? In 2017, the American College of Cardiology lowered what's considered the normal blood pressure range. The upper limit used to be 140/90 mm Hg. It's now 120/80 mm Hg. Lifestyle Changes to Lower Blood Pressure Some people are able to reverse hypertension naturally by modifying their lifestyle. Consider these changes you can make to reduce your blood pressure: Modify your diet: Following a heart-healthy low-salt diet, such as the DASH (dietary approaches to stopping hypertension) eating plan, has been shown to reduce hypertension.Exercise: The American Heart Association recommends getting at least 150 minutes of moderate-intensity physical activity a week. This is the equivalent of walking 30 minutes five days a week, but shorter sessions can help too.Lose weight: If you are overweight or obese, losing weight can help to reduce the stress on your heart and lower your blood pressure. Even dropping just 10 pounds can bring big health gains. Reduce stress: Stress hormones increase your heart rate and blood pressure. Find ways to lower your stress by avoiding stress triggers, reducing your workload, learning to relax, and finding a healthy outlet (like exercise). Stop smoking: Research shows smoking has a damaging effect on your blood pressure. Smokers who quit can significantly reduce their risk of heart attack and stroke.Quit drinking alcohol: Drinking too much alcohol raises blood pressure. The American Heart Association recommends limiting alcohol consumption to no more than one drink a day for females and two drinks a day for males. If you are unable to moderate, you may benefit from quitting entirely. If you have difficulty making any of the above lifestyle changes, your healthcare provider can help you find support resources. When You Shouldn’t Stop For people with non-modifiable risk factors, lifestyle changes may not be enough to lower blood pressure enough to stop blood pressure medications. Causes of high blood pressure that you can't change include: Chronic kidney disease Diabetes Family history of high blood pressure (genetics) Older age Sleep apnea Thyroid disorders and cancers However, treating conditions that contribute to high blood pressure may help lower it. More than 90% of the time, the exact cause of hypertension is unknown. This is called "primary" or "essential" hypertension. If your high blood pressure is due to non-modifiable factors, you may not be able to stop taking your medication. This is especially true as you get older. Age is a risk factor for hypertension. It also makes it harder to manage chronic illness. Risks of Stopping Blood Pressure Medication Always check with your healthcare provider before stopping blood pressure medication. Quitting abruptly may cause rebound hypertension and serious health risks including: Artery damage Enlarged heartErectile dysfunctionHeart failureIncreased risk of aneurysm, coronary artery disease, or strokeMild cognitive impairment or vascular dementiaPotential kidney failureRetinopathy and other eye problems Stopping medication abruptly can cause serious symptoms. For example, the beta-blocker propranolol may cause chest pain or a heart attack if it's stopped suddenly. How to Stop Safely The decision to stop blood pressure drugs needs to be based on: Blood pressure readingsYour overall healthPossible contributing factors and whether they're modifiable Research has yet to establish exactly how long you should have normal blood pressure before stopping meds. But studies suggest waiting anywhere from six months to two years.It may be time to discuss a trial period without medication if: Your healthcare provider thinks your high blood pressure is due to modifiable factors.You make positive changes in those areas.Your blood pressure readings have improved. If your healthcare provider agrees it is safe for you to stop taking your blood pressure medicine, follow their instructions carefully. Depending on the medication, you may need to be at a lower dose for a while before stopping completely. Your healthcare provider can monitor your blood pressure over several weeks while slowly decreasing your dosage to wean off it safely. Is It Safe to Skip a Dose? If you accidentally miss a dose of blood pressure medication, you should take it as soon as you remember, unless it is almost time for your next dose. Do not take more than one dose of medication at a time. Doing so can cause a dangerous drop in blood pressure. Talk About Your Concerns Making healthier lifestyle choices is about more than avoiding medications. It's also about improving the quality and length of your life. Despite lifestyle changes, your healthcare provider may not want you to stop taking blood pressure medication. Listen to their reasons and try not to get discouraged. In addition, your provider's recommendation doesn't necessarily mean you're in poor health. Your provider may just believe the benefits of treatment outweigh the potential risks of stopping. While you might not like taking pharmaceutical drugs, know there's nothing inherently bad about taking hypertension medications. Antihypertensive medications aren't addictive, and the side effects are generally manageable. There are several kinds of blood pressure medication to choose from. Research suggests different types work for different people. Your healthcare provider can help you decide which medication is best for you. Guide to Hypertension Drugs When Your Healthcare Provider May Recommend Stopping Under some circumstances, your healthcare provider may recommend stopping your blood pressure medication. Pregnancy Medications known as ACE inhibitors and angiotensin receptor blockers (ARBs) are not safe to take during pregnancy. If you are taking these medications and trying to conceive or become pregnant, your healthcare provider may change your medication or tell you to stop altogether. Blood pressure drugs commonly believed to be safer during pregnancy include methyldopa and labetalol. If these don’t work, second-line drugs include nifedipine, verapamil, and clonidine, among others. Prior to Surgery Some hypertension medications, such as ARBs like losartan or valsartan, increase the risk of low blood pressure during surgery. If you are having surgery, the surgeon or anesthesiologist will let you know if and when to stop taking your medication. Side Effects Some people have negative side effects from medications that make it difficult to continue taking them. Side effects of common blood pressure medications include: Asthma exacerbation or coughingConstipationDepressionDizzinessErectile dysfunction Fatigue HeadachesHeart palpitationsHigh blood sugarKidney problemsLeg cramps Muscle weaknessSlow heartbeatSkin rash If you are experiencing uncomfortable side effects of blood pressure medication, talk to your healthcare provider. Summary You can change some factors that contribute to high blood pressure, such as eating too much salt or smoking. You can't change others, like age and chronic conditions. With modifiable factors, lifestyle changes may help you get off meds. Talk about this with your healthcare provider. With non-modifiable factors, you may not be able to stop taking medication. Listen to your provider even if you disagree. Blood pressure drugs are generally safe and non-addictive. And if one doesn't work well for you, a different type might. A Word From Verywell Even if lifestyle changes have improved your blood pressure, never stop taking your medication without talking to your healthcare provider. If you don't agree with your healthcare provider's advice, you can get a second opinion. You have the right to make decisions about your health. Just make sure you're well-informed before making changes. Hypertension Treatment Options 19 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology. 2018;71(19):e127-e248. doi:10.1016/j.jacc.2017.11.006 American Heart Association. Changes you can make to manage high blood pressure. National Heart, Lung, and Blood Institute. DASH eating plan. American Heart Association. Getting active to control high blood pressure. American Heart Association. Maintaining weight to control high blood pressure. American Heart Association. Maintaining stress to control high blood pressure. Saladini F, Benetti E, Fania C, Mos L, Casiglia E, Palatini P. Effects of smoking on central blood pressure and pressure amplification in hypertension of the young. Vasc Med. 2016;21(5):422-428. doi:10.1177/1358863X16647509 American Heart Association. Smoking, high blood pressure, and your health. American Hearth Association. Limiting alcohol to manage high blood pressure. Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020;75(2):285-292. doi:10.1161/hypertensionaha.119.14240 Yaxley J, Thambar S. Resistant hypertension: An approach to management in primary care. Journal of Family Medicine and Primary Care. 2015;4(2):193. doi:10.4103/2249-4863.154630 Sun Z. Aging, arterial stiffness, and hypertension. Hypertension. 2015;65(2):252-256. doi:10.1161/hypertensionaha.114.03617 National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Propranolol (cardiovascular). van der Wardt V, Harrison JK, Welsh T, Conroy S, Gladman J. Withdrawal of antihypertensive medication. Journal of Hypertension. 2017;35(9):1742-1749. doi:10.1097/hjh.0000000000001405 Tampa Cardiovascular Associates. Never just stop taking blood pressure medication. Carnovale C, Perrotta C, Baldelli S, et al. Antihypertensive drugs and brain function: mechanisms underlying therapeutically beneficial and harmful neuropsychiatric effects. Cardiovascular Research. 2022. doi:10.1093/cvr/cvac110 Suchard MA, Schuemie MJ, Krumholz HM, et al. Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis. The Lancet. 2019;394(10211):1816-1826. doi:10.1016/s0140-6736(19)32317-7 Brown CM, Garovic VD. Drug treatment of hypertension in pregnancy. Drugs. 2014;74(3):283–96. doi:10.1007/s40265-014-0187-7 American Heart Association. Types of blood pressure medications. Additional Reading Cook R, Lamont T, Martin R; NIHR Dissemination Centre. Lifestyle changes may be more important than drugs for mild hypertension. BMJ. 2019;364:l571. Published 2019 Feb 15. doi:10.1136/bmj.l571 Langan R, Jones K. Common questions about the initial management of hypertension. Am Fam Physician. 2015 Feb 1;91(3):172-7. By Craig O. Weber, MD Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years. 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