Treating high blood pressure, often called hypertension, often requires prescription medications.  Losing weight, watching salt intake, deep breathing techniques, and exercising can make a huge difference in the treatment of high blood pressure, but the sad fact is that many of us need medications for hypertension, even if we do everything right.   The decision to be on medication should be made carefully, and after discussion with your doctor.  You may not have any warning signs- most people who have elevated blood pressure do not know they have it- no headache, no funny feelings,  no warning signs at all.  High blood pressure is called the "silent killer" because it can damage the heart muscle, cause a stroke, or lead to kidney failure without ever causing a symptom

Here are the main things to consider prior to starting BP medications:

  1. Losing weight, exercising, watching salt, and dietary changes such as eating foods rich in potassium remain very important, especially if your blood pressure is borderline, and may still help you avoid being on medication.
  2. White coat hypertension is a major problem.  Getting your pressure checked in the doctor's office is scary- I advise getting readings in a less threatening environment.  Begin a log, with pressures taken either at home, a local pharmacy or supermarket, and bring them with you when you see your doctor.    Use a BP device that is automatic and works on your upper arm, as wrist cuffs are notoriously inaccurate.
  3. Take your BP at different times of the day, as it may vary from morning till night.   It is important to know if your pressure is higher in the morning, or only high when you come home from work- this may affect the timing of when you have to take your medications
  4. If your blood pressure is over 140/90 despite these changes, then medications will be needed to lower your BP.  There are lots of choices of generic (inexpensive) medications available for BP treatment.   If side effects occur, you should not stay on that medication.  But, do not stop it without letting your doctor know.   It is very important to find another medication that works, does not cause ill effects, and is right for you.
  5. A recent study (called the SPRINT Trial) suggests than the ideal target for your systolic blood pressure (the top number) may be below 120 mmHg if you have multiple risk factors for heart disease.

On the 25th day of the program, my doctor said to me:

  1. People who have high blood pressure often have no warning signs, such as a headache, but are at risk of having a heart attack, stroke or kidney failure
  2. Although there are steps that you can take to change your lifestyle to help with blood pressure, many of us need prescription medications.  There are many medications available, and with patience you will find one that has no ill effects, yet controls your pressure

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