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Can you take blood pressure medication forever?

However, many people do require lifelong medication therapy because despite a healthy lifestyle, they still may have high blood pressure due to other intrinsic factors.

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Q1. Can a person taking medication for high blood pressure ever be taken off the meds, or is it a lifelong prescription?

That's a good question, and the answer is heartening too: Just because your physician prescribes blood pressure medication doesn't mean you have to take it forever. Although most people find that taking antihypertensive medication helps to control their blood pressure with relatively few serious side effects, once your blood pressure is under control you may be able to lower the dosage or stop taking the medication altogether by adopting and maintaining a healthy lifestyle. However, many people do require lifelong medication therapy because despite a healthy lifestyle, they still may have high blood pressure due to other intrinsic factors. The good news is that even if you require medications for blood pressure, you can keep the dose down by eating a diet rich in fruits and vegetables, getting regular exercise, maintaining a healthy weight, and not smoking. One word of warning: Often people stop taking their pills once their blood pressure reaches a healthy level, only to find it shoots right back up after a period of time. This fluctuation could be dangerous, so never stop taking your medication without first consulting your physician. And if you are concerned about taking medication for the long term, ask your doctor about alternative ways to control your blood pressure. Good luck.

Q2. My husband always "forgets" to take his blood pressure medication (but I think he just doesn't like taking it). He says he feels fine when he skips a dose or two, but the doctor tells us this is very dangerous to do. How can I help keep him on schedule?

I commend your desire to be your husband's "partner in prevention"! People often have an easier time initiating and maintaining healthy lifestyle changes when those around them provide reinforcement and support. To maintain a healthy blood pressure level, it is essential that your husband follow a healthy lifestyle that includes regular physical activity, maintaining a healthy weight, not smoking or being around others who do, following a heart healthy diet, limiting alcohol consumption, and taking his blood pressure medication as directed. Here are some tips to make it easier for your husband to improve his compliance: Know the purpose of the medication and what the side effects may be. Maintain a regular pill-taking schedule — take medication with meals (if advised) or when you perform other daily tasks, like brushing your teeth.

Put a sticker or note on the medicine cabinet or refrigerator.

Buy pill containers that beep when it's time to take the medication.

Color code the medicine bottles with labels to simplify the routine.

Always pack extra pills and carry your physician's contact information when traveling should you need more pills while you're out of town.

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Your husband should not skip doses or stop taking his medication without first consulting his physician. Often, people stop taking their pills once their blood pressure reaches a healthy level, but find it shoots right back up after a period of time. This could be very dangerous. Uncontrolled high blood pressure is one of the major risk factors for heart attack and stroke. If your husband has concerns about taking medication for the long term, advise him to ask his physician about alternative ways to control his blood pressure. Good luck!

Q3. I had a stroke in May of this year due to high blood pressure. Is there any way to lower blood pressure without prescription drugs?

The short answer to your question is yes – many studies have shown that adopting a healthy lifestyle can lower blood pressure. However, a history of stroke — or heart disease or diagnosed hypertension (140/90 mmHg or higher) — means you may need to take medications in conjunction with modifying your lifestyle to achieve a healthy blood-pressure level.

Here are some heart-smart strategies to incorporate into your life:

Watch your weight. Shed pounds if you are overweight, and maintain your weight if it is already normal. To determine if you're at your ideal weight, use Everyday Health's BMI calculator. Get moving. Try to do 30 minutes of moderate-intensity physical activity, such as brisk walking, on most days of the week — and preferably every day. (But always speak with your physician prior to starting any exercise program.) Follow a healthy eating plan. Consume a diet rich in fruits, vegetables, whole grains, and low-fat dairy products, and decrease your intake of total and saturated fats. Reduce your dietary sodium intake to less than 2,300 mg (or less than one teaspoon of salt) per day. Try substituting salt with other seasonings, such as pepper, garlic, and vinegar. Watch what you drink. For men, limit your alcohol consumption to two drinks or less per day. Women should keep it to one drink or less per day. A drink is equal to 12 ounces of beer, five ounces of wine, and 1.5 ounces of 80-proof liquor.

If you smoke, quit and avoid exposure to secondhand smoke.

Lastly, it's important to know your blood pressure, so have it checked regularly. And if your physician prescribes blood pressure medication, always take it as directed.

Q4. I'm a 59-year-old man with a big problem. My blood pressure meds make me really tired, which is tough when I have to work all day. I'm taking Lasix, Toprol, Norvasc, and Avapro. Is there any way I can lessen the side effects?

There might be. My first suggestion is that you see a physician who specializes in hypertension to review your medications. The goal would be to determine whether your medications can be changed, or the dosages lowered. You are now on three antihypertensive medications along with the diuretic, or water pill, Lasix. There might be another combination that would work for you and lessen the side effects.

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Another strategy is to review your health habits. It may seem counterintuitive to exercise since you say you feel tired, but if you are overweight and aren't already getting physical activity on a regular basis, you may need to get started on an exercise program. For example, walking briskly for 30 minutes four to five times a week can help bring down high blood pressure. You may also benefit from reevaluating your diet — in this regard, reducing portion size is most important as it will help take off extra weight, thereby reducing your blood pressure. It's also very important to control salt intake, because too much sodium contributes to hypertension. Be careful of hidden salt, common in canned goods and snacks. If you need help with crafting an exercise plan and a healthful diet, don't be shy about approaching your doctor for some assistance. Lifestyle changes can go a long way in helping to bring down blood pressure and may ultimately allow you to reduce your dependency on medications.

Q5. My father and my uncle (on my mother's side) both died of atherosclerosis and heart attack in their late 50s. Besides maintaining a good diet and exercise, do you suggest I have any tests to monitor my heart health?

I'm glad to hear that you are interested in playing an active role in your heart health — it's critical to prevention. Having a family history of heart disease increases your risk of developing it. Therefore, it's important that you control your other risk factors for heart disease, including cholesterol levels (LDL, HDL, triglycerides), blood pressure, and diabetes or glucose intolerance. To prevent heart disease, in general, it is recommended that men and women over 20 years old be screened for lipid disorders once every five years. Depending on your age, risk level, or if you are experiencing symptoms of heart disease, your physician may also recommend a diagnostic test like a CT scan or a stress test to evaluate if you have subclinical atherosclerosis.

Learn more in the Everday Health Hypertension Center.

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