Managing High Blood Pressure: Questions About Medication and Lifestyle Changes

Inquiry about antihypertensive medications?

Hello Doctor, I would like to ask you some questions.
After switching to a different blood pressure medication (originally taking a beta-blocker, now switched to a calcium channel blocker, with similar dosages), my blood pressure has been difficult to control (previously around 120-125/70-75; now 145-152/95-102).
I previously consulted my attending physician, who advised me to allow my body to adapt to the new medication, but after nearly a year, I still cannot get my blood pressure below 140/90.
This has made me increasingly anxious, as I am troubled by having high blood pressure at such a young age.
The reason I started medication was due to high blood pressure that caused retinal hemorrhage, so I must control it with medication.
I have some questions for you:
1.
I previously had a BMI of around 32, and now I have managed to reduce it to 25.
What BMI should I aim for to have a better chance of discontinuing medication?
2.
Why does switching to a medication with the same efficacy and dosage result in such different effects? Could my blood pressure have worsened, or is it more likely that I am not suited for the current medication?
3.
If I have high blood pressure but plan to study abroad in the future, will it be difficult to go abroad for my studies? (Considering the potential lack of sufficient prescriptions for medication while living abroad)
4.
Currently, I jog for about 35 minutes/6 kilometers every weekend.
Once I reach a weight below the standard weight, how long does it typically take for blood pressure to stabilize and for me to start reducing my medication dosage?
5.
In clinical practice, are there many cases of young individuals with hypertension successfully discontinuing their medication dependence?
I apologize for having many questions, but I sincerely ask for your responses, as I would like to gather opinions and insights from physicians other than my attending doctor.
Thank you!

Niming, 20~29 year old female. Ask Date: 2014/03/05

Dr. He Dongjin reply Cardiology

Hello, young individuals with hypertension often experience this condition due to overactivity of the autonomic nervous system.
Therefore, taking a beta-blocker may yield better results, while other types of medications may be less effective.
It is recommended to switch back to a beta-blocker.
Additionally, could you increase your exercise frequency to more than three times a week? This should help lower your BMI further.
Based on clinical experience, most patients have hypertension issues primarily due to obesity and stress, and less than 20% of patients require lifelong medication.
Don't be too anxious about it.
Changhua Hospital cares about you.

Reply Date: 2014/03/05

More Info

Managing high blood pressure (hypertension) is a multifaceted approach that involves understanding the condition, medication management, lifestyle changes, and regular monitoring. Given your situation, where you have transitioned from a beta-blocker to a calcium channel blocker and are experiencing difficulties in controlling your blood pressure, it’s essential to address your concerns systematically.

1. Understanding BMI and Medication Dependency: You mentioned that your BMI has decreased from 32 to 25. Generally, a BMI in the range of 18.5 to 24.9 is considered normal. While weight loss can significantly impact blood pressure, the exact BMI at which one can safely discontinue medication varies from person to person. Studies suggest that losing even 5-10% of body weight can lead to meaningful reductions in blood pressure. However, it’s crucial to maintain a healthy lifestyle, including diet and exercise, to sustain these changes.
2. Medication Efficacy: The difference in blood pressure control between the two medications could be due to several factors. Individual responses to antihypertensive medications can vary significantly. Factors such as genetics, lifestyle, diet, and even the presence of other medical conditions can influence how well a medication works. It’s also possible that your blood pressure has worsened due to stress, dietary changes, or other lifestyle factors. If the calcium channel blocker is not effectively controlling your blood pressure, it may be worth discussing with your physician the possibility of adjusting the dosage or considering alternative medications.

3. Traveling Abroad with Hypertension: Traveling abroad with a history of hypertension is certainly manageable, but it requires careful planning. Ensure you have an adequate supply of your medication, as well as a prescription from your doctor. Many countries have regulations regarding the importation of prescription medications, so it’s wise to check the specific requirements of the country you plan to visit. Additionally, maintaining a healthy lifestyle while abroad—such as monitoring your diet, staying active, and managing stress—will be crucial in keeping your blood pressure in check.

4. Exercise and Weight Management: Regular physical activity, such as your routine of jogging, is beneficial for managing blood pressure. It’s recommended to engage in at least 150 minutes of moderate aerobic exercise each week. If you continue to lose weight and reach a healthy weight, it may take several weeks to months to see a significant change in blood pressure. Consistency is key, and it’s important to combine exercise with a balanced diet low in sodium and rich in fruits, vegetables, and whole grains.

5. Cases of Young Hypertensives: There are indeed cases of young individuals with hypertension who have successfully managed to reduce or eliminate their dependence on medication through lifestyle changes. However, this is not universal, and many factors, including the underlying cause of hypertension, play a role. Essential hypertension, which is the most common form, often requires long-term management. Regular follow-ups with your healthcare provider are essential to monitor your condition and make necessary adjustments to your treatment plan.

In conclusion, managing high blood pressure is a continuous process that requires a combination of medication, lifestyle changes, and regular monitoring. It’s important to maintain open communication with your healthcare provider, discuss any concerns you have about your treatment, and explore all options available to you. Remember, while numbers can be concerning, focusing on overall health and well-being is paramount.

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We recommend that you discuss the above situation with your attending physician during your follow-up appointment. Thank you, and wish you good health!