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I’ve Started Exercising, Lost Weight, and Quit Smoking. When Can I Stop My Meds?

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Updated April 11, 2014

Question: I’ve Started Exercising, Lost Weight, and Quit Smoking. When Can I Stop My Meds?
Answer:

This is a common question among patients who have taken steps to improve their health after being diagnosed with high blood pressure. Unfortunately, being a common question does not mean there is a simple answer.

Exercise, weight loss, healthy eating, and abstinence from tobacco are all vital steps in controlling high blood pressure and improving your overall health and lifespan. If you have made these changes, you’re on track to enjoying a longer, higher quality life and your blood pressure should show positive changes as a result.

For many patients, a dedicated program of exercise and weight loss can indeed ultimately lead to normalized blood pressure that does not require medical management. Studies have shown that weight loss can be as effective as drug therapy for treating high blood pressure. Pinpointing the right time to discontinue drug therapy, though, can be difficult. Generally, if your blood pressure has been within the target treatment range for longer than six months and you’ve shown dedication to maintaining your current program, it might be time to talk about doing a “no meds” trial.

If you’ve been losing weight and exercising for six months, but your blood pressure is still above normal, even a little, then stopping medications probably isn’t a good idea. Any elevation in blood pressure above normal levels is associated with an increased risk of heart attack and other cardiovascular problems. So you ideally want the pressures as low as they can get without causing symptoms of low blood pressure. Stick with your program for another six months and see how things go.

For some patients, exercise, weight loss, and other elements of a healthy lifestyle just won’t be enough to control the blood pressure without medication. This doesn’t mean you’ve failed or need to go to extreme levels of exercise or body weight reduction -– people are just different. A lot of this is determined by genetic factors and can also depend on whether you have other problems like diabetes or kidney disease. Some people just have blood pressure that is harder to control. If you’re one of these people, don’t be discouraged. Studies have shown that exercise and weight loss are even more important for you, so you’re getting extra benefit from your efforts.

If your doctor recommends that you keep taking your high blood pressure medications, follow his orders. Remember that there is nothing “bad” about taking these drugs. Sometimes patients can feel pressure from people or groups that advocate “natural” approaches to health and life. But data has consistently shown that drug therapy is the right approach to treating illnesses like high blood pressure. High blood pressure medicines aren’t bad for you, are not addictive, and can carry additional benefits –- like kidney protection –- beyond their blood-pressure lowering effects. Every scientific study that has ever looked at the effects of high blood pressure treatment has shown that patients live longer lives, have fewer complications, and spend less time in the hospital when treated appropriately with drug therapy.

In all cases, it’s important to discuss these issues with your doctor, and not to decide on your own to stop taking your blood pressure medications. It can be dangerous to suddenly stop some medications, and discontinuing drug therapy at the wrong time might make it harder to treat your high blood pressure.

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