Managing Hypertension Medications: When to Stop and Seek Help

Antihypertensive medications

Hello Doctor: Last year, I discovered a heart issue during a health check-up, and after visiting the hospital, the doctor prescribed heart medication.
However, I developed a persistent cough due to a cold (lasting for a month), so I consulted a different doctor who suggested that it might be high blood pressure and that I did not need heart medication (as the medication's side effect is cough).
My blood pressure has mostly been around 120/80 to 105/60.
Initially, I was prescribed Lisinopril 6 mg for control, but the doctor felt the control was not ideal, so recently, they added Amlodipine 20 mg (which also has cough as a side effect).
In early February, I contracted influenza B; although other symptoms have resolved, I still have a persistent cough and a feeling of breathlessness.
Therefore, on February 28, I decided to stop taking Amlodipine, and my cough has somewhat improved.
Can I stop the medication on my own? I was originally scheduled to see the doctor again on March 9, but this morning (March 1), I started feeling a headache and pressure.
However, the original doctor’s appointments are fully booked for tomorrow.
Should I resume the medication, or would it be better to see an ENT specialist for the cough?

eva, 30~39 year old female. Ask Date: 2016/03/01

Dr. He Dongjin reply Cardiology

Hello, there's no need to rush into taking blood pressure medication.
Let's keep a good record for a while and focus on stabilizing your cough first.
Changhua Hospital cares about you.

Reply Date: 2016/03/01

More Info

Managing hypertension effectively requires a careful balance of medication, lifestyle changes, and regular monitoring. In your case, it seems you have been experiencing some challenges with your current medication regimen, particularly with the addition of a new medication that has caused side effects such as coughing. Here’s a comprehensive approach to managing your situation:

1. Understanding Your Medications
You mentioned that you were prescribed Lisinopril (樂壓定) and Amlodipine (優穩壓). Both of these medications are commonly used to manage high blood pressure. Lisinopril is an ACE inhibitor, which can sometimes cause a persistent cough as a side effect. Amlodipine is a calcium channel blocker, which can help lower blood pressure but may also lead to side effects such as swelling or flushing.

2. When to Stop Medications
It is generally not advisable to stop taking prescribed medications without consulting your healthcare provider. While you may have noticed an improvement in your cough after stopping Amlodipine, it’s crucial to consider the potential impact on your blood pressure. Abruptly discontinuing blood pressure medications can lead to rebound hypertension, which may cause your blood pressure to spike.

3. Monitoring Symptoms
You reported experiencing headaches and feelings of pressure in your head. These could be symptoms of elevated blood pressure, especially if you have a history of hypertension. It’s essential to monitor your blood pressure regularly. If you notice significant increases, it may be necessary to resume your medication or adjust your treatment plan.

4. Consulting Healthcare Providers
Since your original doctor is unavailable, consider reaching out to another healthcare provider for advice. You might also want to see an ear, nose, and throat (ENT) specialist for your persistent cough, especially if it has been ongoing since your bout with the flu. They can help determine if there is an underlying issue contributing to your cough that may not be related to your hypertension medications.

5. Lifestyle Modifications
In addition to medication, lifestyle changes can significantly impact blood pressure management. Here are some recommendations:
- Diet: Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing sodium intake can also help lower blood pressure.

- Exercise: Regular physical activity can help manage weight and lower blood pressure. Aim for at least 150 minutes of moderate aerobic activity each week.

- Stress Management: Techniques such as mindfulness, yoga, or deep-breathing exercises can help reduce stress, which may contribute to elevated blood pressure.

- Avoid Tobacco and Limit Alcohol: Smoking and excessive alcohol consumption can raise blood pressure.

6. Follow-Up Care
It’s crucial to have regular follow-up appointments with your healthcare provider to monitor your blood pressure and adjust medications as necessary. If you experience any new symptoms or side effects, communicate these to your doctor promptly.

Conclusion
In summary, while it may be tempting to stop medications when side effects occur, it’s essential to consult with a healthcare provider before making any changes. Monitoring your blood pressure, maintaining a healthy lifestyle, and seeking appropriate medical advice will help you manage your hypertension effectively. If you experience worsening symptoms, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and a collaborative approach with your healthcare team will yield the best outcomes.

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