Hereditary Hypertension: Lifelong Medication and Lifestyle Impact

Regarding hereditary hypertension?

Hello Doctor, due to a family history of hereditary hypertension, I also have issues with elevated blood pressure, which first became apparent when I was 16 or 17 years old.
At that time, the stress of studying combined with a BMI of around 30 led to retinal hemorrhage, prompting me to start taking antihypertensive medication.
Since then, my blood pressure has been well-controlled, but I have a few questions that I hope you can answer!
1.
Once hereditary hypertension is activated, will I need to take medication for life to manage it?
2.
I am very concerned that long-term use of antihypertensive medication might affect my future sexual function.
However, I know that I cannot skip my medication.
Therefore, I would like to ask you, does long-term use of antihypertensive medication really affect sexual function? Are there no antihypertensive medications that do not impact sexual function? (Does the use of beta-blockers necessarily lead to side effects on sexual function? Although I have seen studies indicating that only 10-20% of people are truly affected.)
3.
I currently have a regular routine of jogging on weekends, and I also walk regularly during the week.
My diet is controlled, and my BMI has decreased to around 25.
Will I still have to rely on antihypertensive medication for life? What can I do to reduce my dependence on these medications?

WA, 10~19 year old female. Ask Date: 2013/08/20

Dr. He Dongjin reply Cardiology

Hello, it is difficult to determine if your hereditary hypertension has been activated, as you are currently experiencing stress and have a higher body weight, which can contribute to unstable blood pressure.
I recommend that you consider losing weight; there is a possibility that you may not need medication.
Additionally, you might want to consider switching medications.
Changhua Hospital cares about your well-being.

Reply Date: 2013/08/20

More Info

Managing hereditary hypertension is a multifaceted approach that involves medication, lifestyle changes, and regular monitoring. Given your family history and personal experiences with hypertension, it’s understandable to have concerns about lifelong medication, potential side effects, and the possibility of reducing reliance on antihypertensive drugs. Let’s address your questions one by one.

1. Lifelong Medication for Hereditary Hypertension:
Hypertension can indeed have a hereditary component, and once it manifests, it often requires ongoing management. However, this does not necessarily mean that everyone with hereditary hypertension will need to be on medication for life. The need for medication largely depends on individual circumstances, including the severity of hypertension, response to lifestyle changes, and the presence of any complications (like your previous retinal hemorrhage). Some individuals may successfully manage their blood pressure through lifestyle modifications alone, while others may require medication indefinitely. Regular follow-ups with your healthcare provider can help determine the best course of action for you.

2. Impact of Long-term Medication on Sexual Function:
Concerns about the impact of antihypertensive medications on sexual function are valid. Certain classes of blood pressure medications, particularly beta-blockers, have been associated with sexual side effects, including erectile dysfunction. However, not all individuals experience these side effects, and the incidence can vary widely. It’s important to communicate your concerns with your healthcare provider, as they can consider alternative medications that may have a lower risk of affecting sexual function. For instance, medications such as ACE inhibitors or angiotensin II receptor blockers (ARBs) are often better tolerated in terms of sexual side effects. Your doctor can help you find a suitable medication that manages your blood pressure effectively while minimizing the risk of side effects.

3. Reducing Reliance on Blood Pressure Medication:
It’s commendable that you are actively engaging in physical activity and managing your diet, which are crucial components of blood pressure management. Regular exercise, a balanced diet low in sodium and rich in fruits and vegetables, maintaining a healthy weight, and managing stress can all contribute to better blood pressure control. While lifestyle changes can significantly improve blood pressure, they may not completely eliminate the need for medication, especially in cases of hereditary hypertension. However, if you continue to maintain a healthy lifestyle, it may be possible to reduce the dosage of your medication or, in some cases, even discontinue it under the guidance of your healthcare provider. Regular monitoring of your blood pressure will be essential to assess the effectiveness of your lifestyle changes.

In conclusion, hereditary hypertension often requires a comprehensive approach that includes both medication and lifestyle modifications. While lifelong medication may be necessary for some, others may find that they can manage their blood pressure effectively through lifestyle changes alone. It’s crucial to maintain open communication with your healthcare provider to tailor a treatment plan that suits your individual needs and addresses your concerns about medication side effects. Regular check-ups and monitoring will help ensure that your blood pressure remains within a healthy range while minimizing any potential risks associated with long-term medication use.

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