First of all, let me tell everyone that not all hypertension patients need to take antihypertensive drugs!
According to the latest “Chinese Guidelines for the Prevention and Treatment of Hypertension,” nearly 300 million people in our country have hypertension, which means one in every four individuals has hypertension. About 5% of them have secondary hypertension, meaning it is caused by other specific reasons; the remaining 95% have what we commonly refer to as primary hypertension, which does not have a direct cause but is related to factors such as genetics, obesity, high salt intake, alcohol consumption, lack of exercise, staying up late, high stress levels, and so on.
However, not all hypertension patients need to take antihypertensive drugs.
1. Some patients with secondary hypertension do not need to take antihypertensive drugs
Secondary hypertension can have various causes, including those related to the kidneys, medications, endocrine disorders, severe snoring, and so on.
For example, hypertension caused by medications can return to normal by stopping the medications, so there is no need for antihypertensive drugs; but if the medication must be taken, then antihypertensive drugs have to be used to control the high blood pressure;
For instance, hypertension caused by renal artery stenosis can be resolved through surgery, leading to normal blood pressure levels without the need for antihypertensive drugs;
Similarly, hypertension caused by a pheochromocytoma can be normalized through an adrenal tumor operation without requiring antihypertensive medications.
2. Patients with newly diagnosed primary hypertension may not need to take antihypertensive drugs under certain conditions
For some newly diagnosed cases of hypertension, antihypertensive drugs may not be necessary. According to the “Hypertension Guidelines,” individuals with newly discovered hypertension below 160/100 and no existing damage to the heart, kidneys, or cerebral blood vessels due to diabetes can temporarily avoid antihypertensive drugs. Initially, lifestyle modifications such as exercise, weight loss, reduced salt intake, regular sleep patterns, quitting alcohol, and other comprehensive methods are recommended to lower blood pressure. If the blood pressure returns to normal within about three months, continued adherence to a healthy lifestyle may obviate the need for antihypertensive drugs. However, if the blood pressure remains above 140/90 after three months, antihypertensive drugs should be taken.
But this does not mean that once you start taking antihypertensive drugs, you have to take them for life!
3. Patients with long-term hypertension who have been taking antihypertensive drugs may not need to continue taking them in certain situations
For individuals who have been using antihypertensive drugs, if they can maintain weight control, adhere to exercise, follow a strict healthy diet, avoid staying up late, reduce stress levels, and so on, and their blood pressure improves gradually such that it stays within the normal range without medication, then there is no need for long-term antihypertensive treatment.
A simple way to assess this is to monitor blood pressure regularly. If the blood pressure approaches 90/60, adjustments in medication dosage can be made, reducing or gradually stopping the medication to observe effects.
If for any reason low blood pressure occurs, such as below 90/60, or symptoms of dizziness and fatigue appear when the blood pressure is near 90/60, cessation of antihypertensive drugs is necessary.
As individuals age, blood pressure may decrease in some, leading to the possibility of stopping medication; instances such as a heart attack might result in lower blood pressure, necessitating the discontinuation of antihypertensive drugs; the development of other illnesses could also lead to decreased blood pressure, requiring discontinuation of antihypertensive drugs.
4. For the elderly, the decision to continue antihypertensive medication should be based on specific circumstances
Older individuals, especially those over 80 years old, who have been taking antihypertensive drugs since a young age should monitor their blood pressure. Depending on their symptoms, they should make an informed decision on whether to continue the medication. With advancing age, some people may experience inadequate blood supply to the brain. If the blood pressure drops below 120/70, symptoms of inadequate brain blood supply, such as dizziness, may occur, prompting consideration for reducing or stopping the medication in such cases.
If hypertension is newly diagnosed in the elderly, usually between 65-80 years old, and the blood pressure is above 140/90, initiating antihypertensive treatment may be necessary, provided there are no discomforting symptoms after taking the drugs; for individuals over 80 years old, it is generally recommended to start antihypertensive medication when the blood pressure is above 150/90, given the patient’s tolerance, meaning there should be no discomfort after taking the medication.
If the elderly have blood pressure above 140/90, indicating hypertension, but the blood pressure gradually decreases over time, causing inadequate blood supply to the brain, then the antihypertensive medication may be unnecessary.
In conclusion, not everyone with hypertension needs to take antihypertensive drugs; whether to take antihypertensive medications varies from person to person!
