Do You Need Blood Pressure Drugs? - | AbcVitaminNutrition

Do You Need Blood Pressure Drugs? –

One sometimes overlooked aspect of the new blood pressure guidelines is that doses might need to be raised for people who are already on medications—to help them meet the lower targets for blood pressure, Moran says.

More aggressive treatment should only be undertaken "after making a sustained effort with the lifestyle changes” first, however, Hochman notes. That’s because higher doses, or even adding a drug to your regimen, can hike the risk of potential side effects such as impaired kidney function, or dizziness, which can increase the likelihood of falls, especially in older adults.

When doctors work to reduce the blood pressure of seniors too aggressively, for example, they put them at a “heightened risk for falls and fractures,” says Steven Nissen, M.D., chairman of cardiovascular medicine at the Cleveland Clinic.

“It’s best to be super cautious, especially among the elderly," Nissen adds. "I personally start with the lowest dose of medication possible and then reassess in a couple of weeks."

And according to the new Circulation study’s predictions, with more people taking hypertension drugs or receiving higher doses of those drugs, we might also see more than 3 million more adverse events from drug side effects.

It usually makes sense to start with the oldest, safest, and least expensive drug: diuretics, or water pills, such as chlorthalidone or hydrochlorothiazide.

These can drive up blood sugar levels, however, Nissen says. So if you have type 2 diabetes or are at risk for it, you may need to be monitored closely by your doctor or consider another drug, such as an ACE inhibitor or calcium channel blocker.

If you notice side effects, it’s important to alert your doctor. But don’t just stop taking your medications on your own.

Most side effects are manageable compared with the serious consequences of high blood pressure like heart attack and stroke, according to Circulation study author Adam Bress, Pharm.D., assistant professor at the University of Utah School of Medicine.

If you’ve been on medication for a while and have gotten your blood pressure to target levels, consider talking to your doctor about lowering your dose, especially if you’ve implemented other lifestyle changes such as weight loss and exercise.

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