Stopping Blood Pressure Medication

Clinical judgment is needed to make an informed choice

Woman checking blood pressure in living room.

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Exercising, losing weight, eating healthy, and stopping smoking are all vital steps in controlling high blood pressure and improving your overall health. If you've made these changes, there may be a time when you will no longer need medications to control your blood pressure.

However, knowing when to stop requires you to work with your doctor to honestly assess how sustainable your condition will be without treatment. It's not always an easy answer.

When Stopping May Be Appropriate

To make an informed choice about your need for ongoing treatment, you and your doctor will first need to review the cause (or causes) of your high blood pressure. They may include:

  • Smoking
  • Being overweight or obese
  • Lack of exercise
  • Too much salt in your diet
  • Excessive alcohol intake
  • Older age
  • Family history of high blood pressure
  • Stress
  • Chronic kidney disease
  • Diabetes
  • Thyroid disorders
  • Sleep apnea

While there may be many other contributing causes, what this shortlist illustrates is that some risk factors are modifiable (such as diet and exercise) and others aren't (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 logical reason 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've 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 like family history or variable ones, such as a chronic disease, then stopping treatment may be less appropriate. This is especially true if you're older since age isn't 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, exercise regularly, and stop smoking, a drop in blood pressure may not sufficient enough to warrant a change in treatment.

Having the slightest elevation above normal would not justify the change, especially now that the revised 2017 guidelines have lowered the normal blood pressure threshold from 140/90 mm Hg to 130/80.

It's 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.

Make an Informed Decision

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, listen closely to the reasons. You are not being punished, and the recommendation doesn't mean that you're in "poor" health. It's 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're 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, get a second opinion. In the end, it's your choice to make. Just be sure it's an informed one.

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