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What to do When Your Blood Pressure Won't Go Down

CEO Tinh Phung
Finding and treating underlying causes and making lifestyle changes will help. Many people struggle with high blood pressure as they get older, and sometimes, it can be challenging to control. This condition, known as resistant...

Image Finding and treating underlying causes and making lifestyle changes will help.

Many people struggle with high blood pressure as they get older, and sometimes, it can be challenging to control. This condition, known as resistant hypertension, refers to blood pressure that remains above a set goal, such as 140/90 millimeters of mercury (mm Hg), despite taking the highest tolerable doses of three classes of blood pressure medication, including a diuretic. Resistant hypertension is a significant risk factor for stroke, heart disease, dementia, and more. So, what can you do to tame it?

Reassess all medications

One crucial step is to bring a list of all the medications you are currently taking, including over-the-counter drugs, vitamins, and supplements. This list will help your doctor identify any medications or supplements that may be contributing to your high blood pressure. For example, certain anti-inflammatory drugs, decongestants, antidepressants, and corticosteroids can raise blood pressure. Discussing alternative medications or physical therapy options with your doctor can help reduce blood pressure in some cases. Additionally, your doctor may find ways to streamline your medication regimen, reducing the overall number of pills or the frequency of dosing.

Treat underlying causes

Addressing any underlying conditions that contribute to high blood pressure is essential. However, identifying these causes may require thorough physical evaluation and detective work. For example, sleep apnea, a condition characterized by pauses in breathing during sleep, can significantly raise blood pressure. If you experience chronic loud snoring, gasping for breath during sleep, or excessive daytime sleepiness, a sleep study can help determine if sleep apnea is the underlying cause.

What causes resistant hypertension?

Resistant hypertension can have various causes, such as excessive salt consumption, weight gain, sleep apnea, high alcohol consumption, chronic pain, atherosclerosis causing inflammation in artery walls, drug interactions, panic attacks, high aldosterone levels, kidney problems, and even consuming black licorice.

Make lifestyle changes

In addition to medical interventions, making specific lifestyle changes can have a significant impact on your blood pressure. Start by adopting a plant-based diet low in salt, aiming for less than 2,400 milligrams (mg) of salt per day. Getting at least seven hours of sleep each night, limiting alcohol consumption, avoiding smoking, and maintaining a healthy weight are also crucial. Losing just 5 or 10 pounds can make a meaningful difference in blood pressure for those who are overweight. Regular exercise is another essential lifestyle change. Aerobic exercise, such as walking or cycling, has been shown to lower blood pressure in individuals with resistant hypertension.

In a recent study published in JAMA Cardiology, participants who engaged in aerobic exercise for 40 minutes, three times per week, for 12 weeks, experienced a significant reduction in blood pressure. Their systolic (top number) and diastolic (bottom number) measurements dropped by seven and five points, respectively, compared to those who did not exercise.

What else will help?

If these strategies do not effectively lower your blood pressure, your doctor may prescribe additional medications. However, do not lose hope. Your doctor can make affordable adjustments to your current blood pressure medications to bring your numbers down.

Image Caption: Adopting a healthy lifestyle, including exercise and a balanced diet, can help control high blood pressure.

Remember, managing resistant hypertension requires a comprehensive approach. By reassessing your medications, treating underlying causes, making lifestyle changes, and working closely with your healthcare provider, you can take control of your blood pressure and reduce your risk of related health complications.

Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Consult your healthcare provider for personalized guidance on managing your blood pressure.