How long should you take your blood pressure medication?
Most people ask this question to their doctors. The answer depends on what caused your high blood pressure. If it is a reversible cause which can be removed, then of course medications can be stopped. But if a reversible cause has not been found, you should be cautious about stopping medications.
What are the reversible causes of high blood pressure?
A transient drop in kidney function due to some illness (acute kidney injury) can raise the blood pressure. But when the kidney problem settles, blood pressure normalizes and it may never recur. In this situation blood pressure medication can certainly be stopped.
There are certain rare tumours which secrete hormones which can increase the blood pressure. If these tumours are removed, the blood pressure normalizes and medications can be stopped.
High blood pressure which occurs during pregnancy also normalizes most often after delivery and blood pressure medication can be stopped. But those who develop high blood pressure during pregnancy need long term follow up as they more likely to develop high blood pressure and diseases of the heart and blood vessels later in life.
What about control of blood pressure by lifestyle modification and stopping of medications?
This is often easily said than done. Of course, if one can maintain blood pressure in the normal range by lifestyle modifications, that is always the best. These measures would include maintaining ideal body weight, having a regular exercise program, modifying your diet to avoid high salt diet (not no salt diet, which will bring in other problems!), adding fruits and vegetables to your diet and stress management. If you are already on medications for high blood pressure, it is prudent not to stop them immediately. You have to wait till blood pressure is maintained in the low normal range. Then probably you can start tapering medications under medical supervision. Even in the lucky few who can actually stop the medications with excellent lifestyle modifications, long term surveillance is needed to check for recurrences. Otherwise you might miss out an opportunity as high blood pressure often recurs due to stresses of daily life which also automatically brings down your adherence to lifestyle modifications.