Managing Hypertension After Lymphoma: When to Consider Stopping Medication

Hypertension caused by cancer?

Hello, doctor! I would like to ask about my mother-in-law, who has high blood pressure caused by lymphoma (she was previously healthy, exercised regularly, and had a light diet).
It has been two years since she completed chemotherapy, and she is currently taking one antihypertensive medication.
However, her blood pressure has been around 112 for the past six months, occasionally reaching 130.
The oncologist advised her to continue taking the blood pressure medication.
I would like to know if her blood pressure occasionally dropping to 105 means that continuing the medication could lead to hypotension.
Is there a possibility of discontinuing the antihypertensive medication (considering she still has an artificial blood vessel)? Thank you for your response.

Yang Meiwen, 40~49 year old female. Ask Date: 2023/09/04

Dr. Liu Hongxiang reply Family Medicine

Hello Ms.
Yang Mei-Wen,
The general target for blood pressure control is a systolic pressure below 120 and a diastolic pressure below 80.
The minimum blood pressure standard varies from person to person; a systolic pressure around 100 without other symptoms can be monitored further.
If your blood pressure frequently falls below 110, please discuss with your physician whether to reduce the dosage, switch medications, or consider discontinuing the medication.

Wishing you good health and well-being.

Sincerely,
Dr.
Liu Hong-Xiang

Reply Date: 2023/09/04

More Info

Managing hypertension after cancer treatment, particularly in a case like your grandmother's, requires careful consideration of her overall health, the medications she is taking, and her blood pressure readings. It’s great to hear that she has been active and maintaining a healthy diet, as these factors can significantly influence blood pressure control.

In your grandmother's case, her blood pressure readings averaging around 112 mmHg, with occasional spikes to 130 mmHg, suggest that her blood pressure is generally well-controlled. The standard target for blood pressure management is typically below 130/80 mmHg for most adults, and it appears that she is within this range. However, the concern about her blood pressure occasionally dropping to 105 mmHg is valid, especially if she experiences symptoms such as dizziness, fatigue, or fainting.

The decision to continue or discontinue antihypertensive medication should be made in consultation with her healthcare provider. Here are some considerations:
1. Monitoring Blood Pressure: Regular monitoring of blood pressure is essential. If her readings consistently remain low (e.g., below 100 mmHg systolic) without any symptoms, it may be appropriate to discuss with her doctor the possibility of reducing the medication dosage or even discontinuing it.

2. Medication Adjustment: If her blood pressure is frequently on the lower side, her doctor might consider adjusting her medication. This could involve reducing the dosage or switching to a different class of antihypertensive that may have a milder effect.

3. Symptoms: If your grandmother experiences any symptoms related to low blood pressure, such as dizziness, lightheadedness, or fatigue, it is crucial to report these to her healthcare provider. These symptoms can indicate that her blood pressure is too low, and her medication may need to be adjusted.

4. Underlying Conditions: Given that she has a history of lymphoma and has undergone chemotherapy, it’s important to consider any potential long-term effects of cancer treatment on her cardiovascular health. Some cancer treatments can affect heart function and blood pressure regulation, so her oncologist or a cardiologist may need to be involved in her care.

5. Lifestyle Factors: Encourage her to maintain her healthy lifestyle, including regular exercise and a balanced diet, which can help manage blood pressure naturally. Stress management techniques, such as mindfulness or yoga, can also be beneficial.

6. Artificial Vascular Considerations: Since she has an artificial blood vessel, it’s important to consider how this might affect her blood pressure management. Any changes in her medication should be done cautiously and under medical supervision.

In conclusion, while it is possible for her to consider stopping or adjusting her blood pressure medication, this should be done in close consultation with her healthcare provider. They can provide personalized advice based on her specific health status, medication history, and overall treatment plan. Regular follow-ups and open communication with her medical team will ensure that her hypertension is managed effectively while minimizing any potential risks associated with her cancer history and current medications.

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