"When can I stop taking my high blood pressure drugs ?" is a question many a hypertensive has either asked or wondered about.........
What's On This Page
- What is High Blood Pressure - Meaning and Numbers?
- Which People Are at Risk of getting High Blood Pressure?
- Why Would I Want To Stop Taking My Blood Pressure Drugs?
- Common Reasons For Stopping Drugs
- So, When CAN you stop taking your Blood Pressure Drugs?
- Illness That Could Severely Reduce Your Blood Pressure
- Longterm Benefits
What is High Blood Pressure - Meaning and Numbers?
Let’s start today’s chat by setting some background:
High BP (Hypertension) is one of the biggest risks for serious ill health and death. Your BP is the essential force your body needs to ensure blood moves around it effectively to do its job.
If the BP gets excessively high, the followig problems could develop
- risk of stroke, damage to the blood vessels of the heart causing problems like Angina and Heart Attack,
- damage to the heart muscle causing Heart failure
- long term and severe kidney problem
- Memory problems and premature deaths
These make emergency hospital visits more likely; hospital admissions and of course personal and public health care costs
What are Normal Blood Pressure Readings?
A lot of health practitioners agree that (Based on the 2017 ACC guidelines), normal adult BP should be less than 120/80 mm Hg. (US)
•US - Stage 1 (Earliest stage) HTN is classified as systolic BP 130–139 or diastolic BP 80–89 mm Hg.
•UK - Stage 1 (earliest stage) hypertension is a clinic blood pressure of between 140/90 mmHg and 160/100 mmHg, (if it’s measured in the clinic/hospital) and ambulatory daytime average or home blood pressure average of 135/85 mmHg or higher.
Which People Are at Risk of getting High Blood Pressure?
Hypertension is a global health problem and can affect nearly everyone regardless of age/gender/occupation or social status.
What CAUSES high blood pressure to start?
In most cases – we do NOT KNOW. However, it is more common in:
- advancing age,
- women aged between 65–74 years
- and people of black African or African-Caribbean origin.
- (Other risk factors include social deprivation, lifestyle factors, anxiety, and emotional stress.
Some Conditions Associated with High Blood Pressure
In a smaller number of cases, we do know some conditions where Blood Pressure goes up – a few examples:
- Hypertension in Pregnancy – Can develop in early or later pregnancy (before and after 20 weeks)
- including a severe form of high blood pressure in pregnancy known as Pre-eclampsia – a condition in pregnancy where blood pressure is very high – which emphasises the need for antenatal care (ANC) monitoring.
- (pregnant women with chronic hypertension, gestational hypertension or pre-eclampsia should be referred to a specialist.
- Symptoms of pre-eclampsia include
- severe headache,
- problems with eyesight,
- severe pain below ribs,
- and the sudden swelling of hands, feet or face
- accompanied by large amounts of protein in the urine
- and blood pressure greater than 140/90 mmHg.
- Kidney Disease can cause High BP - whether it is an acute or chronic injury; (see highlighted section). (High BP causes Kidney Disease)
- Drugs - these may be prescribed like steroids or oral contraceptive pills and some HRT; illicit (street) drugs LIKE Cocaine or stimulant containing drinks taking in excess quantities like Caffeine
- Conditions like Diabetes Mellitus
The following conditions are linked to developing serious Kidney disease • Conditions affecting the Heart and Blood Vessels (Cardiovascular disease) •Proteinuria (conditions where there is protein in the urine) • Acute kidney injury – dehydration/shock/ drugs • Hypertension • Diabetes • Smoking • Being from an African, African-Caribbean or Asian family origin • Long term use of NSAIDs (non-steroidal anti-inflammatory drugs) • Untreated urinary outflow tract obstruction
Why Would I Want To Stop Taking My Blood Pressure Drugs?
After a diagnosis with high blood pressure, we want people to understand that in most cases it is a long term treatment. Generally, people will take these medicines for several years to maintain blood pressure control.
Most times high blood pressure in the very early stages does not have any symptoms – making it difficult for people to reconcile taking daily tablets when you don’t feel ill.
It's very worrying that despite knowing that high BP can cause serious illness, we are still not succeeding around the world in getting good control of hypertension.
Now, what are these barriers?
As you can see from this image several factors can lead to poor blood pressure control, such as See photo on next page - lack of access to medicines, receiving consistent care from HCW including the type of medicines they should have and other treatment.
Another important barrier to getting control is the behaviour of people with high blood pressure when it comes to how they take their drugs.
Out of those reasons, let’s look at the behaviour of some people with high BP and why they stop taking their BP Medicines
Common Reasons For Stopping Drugs
- Lack of Awareness for the consequences of untreated high blood pressure and the aims for remaining on treatment – people don’t worry about high blood pressure because they don’t feel unwell.
- Therefore, they do not know the possible severe side effects till it’s too late; or they do not know that blood pressure treatment is a long term goal in most cases rather than a short course. - compare paracetamol/headaches
- Medication Side effects – This is one of the biggest issues. It is true that the side effects of high blood pressure drugs can be quite serious and intolerable.
- Hence, the natural response or behaviour is to stop them – but that only solve one part of the problem – the side effects and leaves the original problem.
- People should know that there could be options like alternative treatments which they can tolerate better.
- Poor medication use/Compliance – I call this having the attitude of "I'll take it when I remember or if I feel ill".
- This is human behaviour that can develop for many reasons – lack of knowledge about the treatment aims, being naturally forgetful, or just plain carelessness
- Not having follow up with your Doctor/Nurse/ Pharmacist etc – Monitoring is important to learn the progress of treatment and help your doctors make the right decision.
- When you do develop high blood pressure, part of what is important as taking treatment is keeping track of your blood pressure and any other tests recommended – like blood tests for your kidneys, or an electrocardiogram (ECG) for the heart.
- Personal Wishes, Desires or Preference - Though it comes at the end of the list, this a key and valid reason you and many other people have.
- Not wanting to take any drug treatment as a choice; simply not wishing to have drugs (chemicals) in the body is a reason many people would like to stop their blood pressure drugs. Non-drug treatment (see shaded box below) or natural therapy is a choice they prefer.
As you will probably agree, there are so many reasons that could stand in the place of continuing blood pressure treatment that one could face.
Where Natural Therapy Can Fit In Your Blood Pressure Treatment
- Natural therapy could be supplements or herbal preparations that may have a reducing effect on blood pressure. Most often, we do not have enough studies to determine how reliable they could be in a large group of people; any side effects or how well they work.
- However, natural treatment is not suitable for everyone. Most doctors recommend a combination of drug and non-drug treatments.
- Relying on non-drug treatments only should be combined with strict monitoring of your blood pressure. It is essential that if the method is not working, you should have other options.
Non-Drug Treatment for High Blood Pressure
This is an essential part of controlling high blood pressure.
In many people, a combination of drug and non-drug treatment is essential to achieve our goals.
In patients with suspected or diagnosed hypertension, lifestyle advice and support can help us make healthy lifestyle changes. They include regular exercise, a healthy diet, low dietary sodium intake, and reduced alcohol intake (if excessive). Other measures include avoiding too much coffee and other caffeine-rich products and to stop smoking.
So, When CAN you stop taking your Blood Pressure Drugs?
Essentially, NOT without advice from your Doctor.
Only in association with your Dr – the general practitioner or specialist should you stop taking your blood pressure drugs.
AVOID one-sided decisions or from people who are NOT qualified (not a reputable doctor, nurse pharmacist or other recognised similar health practitioner).
These are a few circumstances when people can come off their drugs for treatment.
Following Delivery of A Baby
After birth for a woman who had high blood pressure in pregnancy, your antihypertensives should be reviewed 2 weeks after birth.
This is part of the postnatal checks and will include blood pressure monitoring.
If you were treated for hypertension during pregnancy, you should have a medical review 6-8 weeks after birth with the GP or specialist.
In some cases the drugs can be stopped, while in other cases it's necessary to continue taking blood pressure drugs.
After Treatment of Known Causes
If the issue causing the blood pressure to rise (e.g from drug related causes like steroids, or oral contraceptive pills) stops, it is possible to come off the medicine. You will still require regular monitoring of the blood pressure (and follow up).
Considering Non-Drug treatments ALONE
This option is NOT FOR EVERYONE.(see above segment on non-drug treatments.
Even if you want to use non-drug treatments alone, speak to your doctor about your preferences. Continuous monitoring is necessary to know if the method is working for you or not.
Side Effects from Antihypertensive Drugs
Different blood pressure drugs can cause so many different side effects. While your doctor should let you know what to expect with any new medicine, you must always ask as well.
If you do develop any side effects, please discuss them with your doctor. Many of the side effects may be irritating more than harmful but regardless, they could still prevent you taking the treatment properly.
Illness That Could Severely Reduce Your Blood Pressure
If you are very ill with another problem that could affect your blood pressure, continuing the tablets may lead to very low blood pressure.
A good example is when you experience excess vomiting and diarrhoea which could cause dehydration. This alone can reduce your blood pressure very much.
Your doctor will therefore like you to recover from this to avoid the risk of reducing the blood pressure too much if you take the tablets.
Effect of Advancing Age on Blood Pressure
While it is correct that high Blood Pressure occurs more with advancing age in some people, in others blood pressure reduces.
We think this may be due losing weight (muscle and fat) with age; or chronic medical conditions whose toll can affect the blood pressure.
This means they may have low blood pressure at rest and will no longer need the drugs to lower the blood pressure. In fact, if they do continue, they may develop side effects like dizziness making them faint or fall; kidney problems or heart disease.
In this group, we would rather stop the drugs than risk worsening their health.
Having open discussions about your preference with your doctor (or nurse/pharmacist), and being confident of the benefits you will get from your drugs is key to your ongoing wellbeing.
So if you have been contemplating - when can I stop taking my high blood pressure drugs, it's a valid question.
Hopefully, some of the reasons we looked at here can help.
Trying to find out why people stop taking their drugs is important
If you feel or have felt like this before - please let us know in the comments section what your reasons are (were). Stay Well.