“Why isn’t my blood pressure medication working? Why do I need more blood pressure medication?” These are two of the most frequent questions that my high blood pressure patients ask me. Most of my patients are concerned or frequently disappointed when their blood pressure is not controlled, especially when they are taking their blood pressure medications on a regular basis.
Over the years, I‘ve found that there are several reasons for medication “resistance,” and there’s a good chance that their blood pressure medication is working the way it should. In many cases poor blood pressure control or the need for more medication can be tied to unhealthy behaviors and a lifestyle that is working against you. It’s important for patients with high blood pressure to understand that healthy lifestyle changes together with blood pressure medication can lower blood pressure and minimize the need for more medication.
High blood pressure—or hypertension—is a serious medical condition that can increase your risk of stroke, cardiovascular disease, heart attack, and kidney disease. If left untreated it gets worse and progresses to more severe stages. Hypertension can occur at any age, but clearly occurs more frequently in older populations, as more than two-thirds of individuals over 60 have hypertension. High blood pressure rates and organ damage are also higher in blacks than whites. If you really want to keep your blood pressure in check, it’s important to speak with your healthcare provider, and make certain lifestyle changes, such as:
Reducing your sodium (salt) intake: If you have high blood pressure, diabetes, or chronic kidney disease, or you’re middle-aged or older or black, the general rule is that you should consume no more than 1,500 milligrams each day
Exercising: At least 30 minutes of moderate activity 5 days per week can help you manage your weight, strengthen your heart, and manage your stress levels—all of which play an important role in controlling your blood pressure. Be sure to check with your healthcare professional before starting a new exercise program
Lose weight, or maintain an ideal body weight: In one study over half of those overweight patients with mild (stage 1) hypertension, normalized their blood pressure with a 5% weight loss. The bottom line: It didn't take a whole lot of weight loss to help curb high blood pressure
Limiting alcohol: Drinking too much alcohol can raise your blood pressure. In general, more than one drink a day for women and more than two for men is too many
Taking your blood pressure medicine as prescribed: Put your prescription in your brief case or next to your toothbrush—whatever you need to do to remind yourself to take your medication and make it part of your routine
Adopting healthier habits can seem daunting to some. But when it comes to lowering your blood pressure, there’s no easy way around steps like the ones above. On many occasions, I have had to reduce the amount of blood pressure medication that a patient is taking when they have made one or more of these lifestyle changes.
One of the most rewarding experiences I have as a doctor is seeing a patient stick with a healthier lifestyle and then be rewarded with improved health outcomes they can easily measure. So if you’re taking medication to lower your blood pressure, keep up the good work—but don’t forget to talk to your doctor about the lifestyle steps you can take and you may see your blood pressure numbers continue to fall into a range that’s the right one for you.
Daniel Wilson, M.D., was a Global Medical Director at Pfizer. He is a recognized kidney and hypertension specialist, and a fellow of the American College of Physicians.