Dr. Charlyce

If you are living with high blood pressure, likely you are taking a combination of medications to keep your numbers in control. It is common for patients with high blood pressure to take up to 3 medications following the advice of their doctors.

If you have more than one chronic condition, it is likely you take 3-5 prescription medications just to manage your blood pressure. 

Many patients stop blood pressure medications suddenly. Many patients can’t tolerate the side effects of prescribed medications. Others find that the prescribing regimen is too complicated to follow accurately. Prescription medications can be expensive, particularly combinations of medications. This leads to some patients not filling prescriptions due to cost. 

Before you stop your blood pressure medications, here are some important questions to consider. 

What Happens When You Stop Taking Blood Pressure Medications Suddenly?

There are several types of blood pressure medications. They are classified by how they work. Understanding what happens if you stop a blood pressure medication suddenly starts with knowing which type of medication you are taking.

Type of Hypertension Medications

• ARBs (examples: Losartan, Valsartan): ARB’s work by blocking a hormone that raises blood pressure in the kidneys.
• ACE Inhibitors (examples: Lisinopril, captopril): ACEi’s work by blocking an enzyme that raises blood pressure within the arteries.
• Alpha Blockers (examples: Clonidine): Alpha blockers block adrenaline-like hormones from working on the heart and the blood vessels.
• Beta Blockers (examples: Atenolol, Metoprolol): Beta blockers block hormones produced in the adrenal glands from working on the heart, which causes the heart to beat slower and relaxes blood vessels.
• Calcium Channel Blockers (examples: Amlodipine, Nifedipine): Calcium channel blockers slow down a chemical reaction within the cells of arteries and the heart which leads to slowing down the heart rate and relaxing the muscles of the heart.
• Diuretics (examples: Hydrochlorothiazide, Furosemide): Diuretics cause the kidneys to release electrolytes in the urine, which causes water loss. The overall effect is lowering blood pressure by lowering the volume of water in the blood vessels.
• Vasodilators (examples: Hydralazine, Minoxidil): Vasodilators relax the blood vessels in the entire body, which lowers blood pressure.

You never want to stop blood pressure medications without the guidance of your physician. Stopping medications abruptly can lead to dangerous side effects. Alpha Blockers are the most dangerous to stop abruptly. If you’ve been taking an alpha blocker on a regular basis and stop it abruptly, you can develop Rebound Hypertension.¹ Rebound Hypertension is a sudden rise in blood pressure after stopping a medication. Rebound blood pressures can be very high, up to nearly 200 systolic, increasing your risk of a stroke or heart attack.

Beta blockers and calcium channel blockers can also cause rebound hypertension.

Stopping diuretics suddenly can cause fluid retention, or edema. Diuretics can be stopped over time, but only after addressing the root cause of your high blood pressure.

ARB’s and ACEi’s can safely be deprescribed only after healing the root cause of your high blood pressure. Stopping these medications before knowing what’s causing your high blood pressure will likely lead to your high blood pressure returning. 

Rather than stopping your blood pressure medications abruptly, you should work with your doctor or a qualified Functional Medicine physician on a plan to address you high blood pressure holistically.

Can You Stop Blood Pressure Medications after Weight Loss?

Some patients may have a reversal of metabolic diseases related to obesity. If you’ve recently had a significant weight loss, such as after medication or with weight loss surgery, it may be time to reassess which medications you still need to take.

It takes a careful, personalized approach on when, how, and which medications should be withdrawn. Some medications may be stopped quickly without dangers of withdrawal. Diuretics, for example, can often be stopped without consequence if you are otherwise healthy.

If you have high blood pressure, it is likely you are treated for another condition such as diabetes or coronary artery disease. This means that even if your overall numbers are better, you may still require treatment for high blood pressure because your medication is preventing another disease.

ARB’s and ACEi’s are used to prevent kidney disease in diabetics. Many doctors prescribe low doses of these even when patients have normal blood pressure to protect the kidneys from damage from diabetes.

If you have a history of heart attack or have angina, you may not be able to stop Beta Blockers. Beta blockers prevent the coronary arteries form contracting, which stops angina and prevents heart attack.

If you are mostly healthy, it may be possible to stop blood pressure medications after weight loss, but only with a careful plan to monitor your blood pressure.

How Do I Get Off Blood Pressure Medications Naturally?

Coming off blood pressure medications naturally is possible for almost every patient. When you are getting the care you need holistically, you can come off of blood pressure medications naturally and safely.

The first step to coming off blood pressure medications is addressing what caused your high blood pressure. This is the hardest step, since there are likely several factors that led to you having high blood pressure. 

Causes of High Blood Pressure

1. Obesity
2. Standard American Diet
3. Stress
4. Sleep Disorders
5. Hormonal Imbalance
6. Lack of Healthy Movement

Coming off blood pressure medications naturally means addressing every factor in your life that led to high blood pressure. Working with a functional medicine doctor, you can get holistic guidance on making lasting changes to heal your high blood pressure.

References:

1. What to know about rebound hypertension