If blood pressure returns to normal, can hypertension medication be stopped? Many friends who have high blood pressure have this question. The reason why friends want to stop taking antihypertensive drugs is mostly due to concerns about the side effects of antihypertensive medication. Some people even believe that taking antihypertensive drugs for a long time can damage the kidneys and lead to kidney failure. Is this true? Today, Dr. Zhang will discuss this issue with everyone.
Why doesn’t the doctor allow stopping the antihypertensive drugs when blood pressure is normal?
The reason why doctors do not allow stopping antihypertensive drugs is that hypertension is a chronic disease, unlike colds, infections, and other diseases. Colds and similar illnesses, once the viruses or microorganisms in the body are cleared, there are no longer factors leading to the disease, so medication can be stopped.
However, primary hypertension is different; there are many factors that lead to primary hypertension, and many of them cannot be completely eliminated. The reasons for high blood pressure are often not just one factor; most are the result of multiple factors working together. Common factors leading to high blood pressure are divided into endogenous and exogenous factors.
Endogenous factors include: rapid heartbeat, high vascular tension, excessive vascular contents, etc.; exogenous factors include: high-salt diet, obesity, mental stress, unhealthy habits, etc. These internal and external factors work together to cause high blood pressure.
Currently, there are a total of 5 commonly used antihypertensive drug classes: ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics. Among all these medications, no single drug or combination of drugs can fundamentally eliminate the cause of hypertension; they can only alleviate the symptoms, maintain stable blood pressure. Once antihypertensive drugs are discontinued, blood pressure will return to a high level, triggering a series of serious complications such as heart disease, stroke, cerebral hemorrhage, and kidney function failure.
Therefore, friends with hypertension should not stop medication casually. So, is it the case that all friends with hypertension cannot stop taking medication? Not entirely. When the following 3 conditions occur, stopping medication can be considered.
Under what conditions can stopping medication be considered?
1. Primary hypertension without high-risk factors
If blood pressure is below 160/100, it is called primary hypertension. Primary hypertension is more common in middle-aged and young people. The high blood pressure in these friends is mainly due to stress, unhealthy diet, and bad habits. With strict lifestyle control, there is hope for their blood pressure to return to normal.
When the blood pressure of these friends returns to normal, they can try to gradually reduce the medication dosage until stopping the medication. However, this process must be slowly carried out under the guidance of a doctor; one cannot be hasty but should gradually reduce the dosage. If one week after stopping the medication, the blood pressure remains within the normal range, then complete discontinuation of the medication may be considered. However, they still need to maintain a healthy lifestyle and strictly monitor their blood pressure.
Another prerequisite for stopping the medication is that these friends must not have other high-risk factors and should not have diabetes, hyperlipidemia, hyperuricemia, or a history of cardiovascular and cerebrovascular diseases. If high-risk factors or a history of cardiovascular and cerebrovascular diseases are present, it is not recommended to stop the medication.
2. Low blood pressure after medication
Some friends, after taking antihypertensive drugs, have blood pressure below the normal value. Generally, for friends with hypertension, blood pressure should not be lower than 120/70. If after taking antihypertensive drugs, the blood pressure is lower than this range, reducing the antihypertensive drug dosage can be considered. If even at the lowest effective dosage of the medication, the blood pressure still remains below 120/70, stopping the medication can be considered. Similarly, one week after stopping the medication, if the blood pressure remains within the normal range, complete discontinuation of the medication can be considered. Lifestyle habits need to be controlled, and blood pressure should be monitored promptly.
3. Hypertensive patients whose blood pressure is significantly affected by the season
Some friends with hypertension experience a return to normal blood pressure levels in warmer weather. They can temporarily discontinue the medication during this period. However, when the weather turns cold again, they should resume taking the medication promptly to prevent a sudden increase in blood pressure, which could lead to the occurrence of cardiovascular diseases and not be worth the risk.
Aside from these three situations, doctors do not recommend stopping medication for other friends with hypertension. Some friends may question that they have stopped taking their medication for a few days, and their blood pressure did not show abnormalities. This is because many friends are on long-acting antihypertensive medications, and after a brief cessation of the medication, blood pressure will not show abnormalities. However, as the medication in the bloodstream decreases, blood pressure can rebound, leading to a sharp increase in blood pressure, which can easily trigger severe complications such as cerebral hemorrhage and heart disease.
What is the ideal range for controlling blood pressure?
For friends with hypertension, the ideal blood pressure level varies in different age groups. If you are under 65 years of age, it is best to adjust your blood pressure below 130/80, but not lower than 120/70. The likelihood of complications occurring is minimal within this range. Within this range, you can try to reduce the dosage to maintain ideal blood pressure with the smallest effective amount of medication.
If you are 65 years of age or older, the requirements can be relaxed; it is sufficient to control the blood pressure below 140/90. This is because people over 65 years of age have more severe arteriosclerosis; if the blood pressure is reduced too low, it requires a large amount of medication, making it easy to trigger medication side effects.
Conclusion
For most friends with hypertension, it is not recommended to stop taking antihypertensive medication. This is because antihypertensive drugs cannot eliminate the root causes of hypertension. They can only maintain blood pressure within a normal range, reducing the occurrence of complications.
There are three groups of people who can consider stopping medication, namely: primary hypertension without any complications, without high-risk factors, whose blood pressure can return to normal after strict lifestyle management; those with low blood pressure after taking antihypertensive drugs, even at the lowest dosage, and whose blood pressure still remains below 120/70; friends with hypertension whose blood pressure is significantly influenced by season, can temporarily discontinue the medication when their blood pressure is low during the season.
Regardless of the group, close observation of blood pressure changes is necessary, and if an increase occurs, prompt resumption of medication is required.
About the question “Can hypertension medication be stopped?”, this is where today’s discussion ends. If you agree with Dr. Zhang’s views, feel free to follow, like, or leave a comment. Your support is appreciated as creativity is not easy. If you have any other questions or opinions, feel free to leave a comment. Good questions are a vital source of inspiration for me. Thank you in advance. This is Dr. Zhang Wei, a divine external doctor, and see you next time.
References
【1】Fedak KM, Good N, Walker ES, Balmes J, Brook RD, Clark ML, Cole-Hunter T, Devlin R, L’Orange C, Luckasen G, Mehaffy J, Shelton R, Wilson A, Volckens J, Peel JL. Acute effects on blood pressure following controlled exposure to cookstove air pollution in the STOVES Study. J Am Heart Assoc. 2019;8:e012246.65. Stergiou GS, Palatini P, Modesti PA
#Side effects of antihypertensive drugs#
