Dear Doctors: My doctor recently increased the dosage of my blood pressure medications. I want to try a natural route to reduce high blood pressure, but it appears that is for people not taking any drugs. How should I approach this issue? Can I stop my meds and go natural?
Dear Reader: Blood pressure is one of the most important metrics of general health. The information gathered in that quick and simple test sheds light on cardiovascular workload and risk. It can warn of issues with other organs, including the kidneys and the brain. Chronic high blood pressure leads to narrowing, thickening and damage to the arteries. It can also lead to a loss of elasticity. It also puts you at increased risk of heart disease, heart attack, stroke, kidney disease and cognitive decline. All of this makes your questions about blood pressure medications and lifestyle very relevant.
A blood pressure reading reflects how hard blood is pressing against the artery walls. Readings are measured in millimeters of mercury, or mmHg. Values are also presented as a fraction. The top number is systolic pressure. It measures the force of blood as the heart contracts. The lower number is known as diastolic pressure (think d for down). It measures blood pressure between beats when the heart is briefly at rest.
Blood pressure under 120/80 is considered normal. A systolic reading of 120 to 129 with a diastolic reading under 80 is elevated. Readings of 130/80 and above enter the realm of hypertension. At that point, depending on the person's specific readings, general health and medical history, medications may be prescribed. These drugs manage blood pressure in several ways. They can relax the arteries, ease the force or speed of the heart, and reduce sodium and promote fluid removal. For many adults with high blood pressure, readings below 130/80 are the target for treatment.
When working with our own patients living with elevated blood pressure, we make the following offer: We can give you a prescription or we can coach you to heal yourself. Selecting the latter means a focus on lifestyle choices. Those include good nutrition, lower sodium intake, regular exercise, quality sleep, stress regulation, no tobacco products and a healthy weight. If levels remain high once these measures are optimized, medications are the next step. Some people with excellent lifestyle habits still need medication to manage hypertension. Age, genetics and underlying conditions also play a key role in blood pressure.
Your doctor's recommendation to increase your medication suggests that your blood pressure is not yet well-controlled. We appreciate your wish to avoid medication but stopping the treatment on your own is not wise. Unless you have already maintained big lifestyle changes, your blood pressure is likely to go up again. Get your doctor's help in "going natural." They can help you gradually wean off the medication, checking blood pressure values with each decrease. If you can reach and maintain a blood pressure goal of 130/80, then congratulations -- you have graduated.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
