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Managing the ‘silent killer’ of blood pressure

In the Leinster Express’ medical column, Dr Ashfaq Ahmad of the Boston Health Centre in Portlaoise dispenses invaluable advice on a host of conditions and ailments.

Managing the ‘silent killer’ of blood pressure

Q: My mother has high blood pressure. Initially her blood pressure was difficult to control, but now she is on three medications and her blood pressure is normal. She feels tired and wants to come off her medications. Can she quit her medications as her blood pressure is normal? And if not, what is the best medication for high blood pressure?

The Doctor says: High blood pressure or hypertension is a chronic disease and a major risk factor for heart disease, kidney disease, and stroke. Adequately treated patients are less likely to develop complications of high blood pressure. High blood pressure is a chronic condition and requires lifelong medications. Only in rare cases may patients be able to come off blood pressure medicines. Your doctor can adjust medications according to your blood pressure. If blood pressure is too low, medicines can easily be adjusted.

However, discontinuation of blood pressure medication on your own can cause a sudden increase in your blood pressure, which can lead to heart failure or stroke. Therefore, it is always advisable to continue with your medications and call your doctor if blood pressure is too low or the patient is feeling weak or overly fatigued. Lifestyle changes help in conjunction with closely monitored medication regimen. Lifestyle changes such as dietary salt re-education, weight loss, exercise, quitting smoking, and reduction in alcohol intake does help in the management of hypertension. 

Medication management of high blood pressure is not straight forward. There are multiple medications in the current market for treatment of high blood pressure. Every medication has its own benefits and side effects, majority of the doctors start patients on medications which have long proven benefits and least side effects. 

Diuretics (water pills), ACEI-inhibitors, beta blockers, calcium channel blockers and alpha-blockers are among the most common groups of medications to treat high blood pressure. Studies have shown that most patients require two or more blood pressure medications to control high blood pressure. I advise your mother to visit her doctor to discuss her blood pressure management, as she could be experiencing weakness as a side effect of blood pressure medication.

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