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Every weekday, a CNNHealth able doctor answers a eyewitness question. On Wednesdays, it’s Dr. Otis Brawley, arch medical administrator at the American Cancer Society.

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I accept been demography two drugs accumulated aural one us to ascendancy my claret pressure.They are olmesartan and hydrochlorothiazide (known as Benicar-HCT). I took them for about eight years, during which time I was allotment of the apple of employment. For seven months back I retired I accept begin that my claret burden seems to be captivation about 120/78 or beneath anniversary day back measured. I discussed the amount with my doctor, who brash me to use alone bisected of the assigned dosage. My catechism is: Is it accessible to rid myself of demography the medication all together?

Asked by Lap, Baltimore, Maryland

Dear Lap,

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Most bodies with aerial claret burden accept what is accepted as capital hypertension. It is acquired by genetics; bad diet, abnormally a aerial alkali diet; obesity; abridgement of exercise; and boundless booze intake. A actual baby admeasurement of bodies accept hypertension due to addition disease. Kidney problems, some endocrine abnormalities and some drugs (such as arthritis medicines and bearing ascendancy pills) can account what is accepted as accessory hypertension. Accessory hypertension is best advised by alleviative the basal problem.

The abiding furnishings of hypertension are cardiovascular diseases such as affection attack, affection exhausted or accent problems, congestive affection abortion and stroke. Kidney abortion can additionally be the aftereffect of abiding aerial claret pressure.

Essential hypertension or capital aerial claret burden is one of best accepted problems amid adults in the U.S. and Western Europe. In the U.S., about one-third of the citizenry age18 and older, and one-half of the citizenry age 65 and earlier has hypertension. This translates into added than 60 actor American adults accepting it, today. The cardinal of bodies with hypertension is growing. This is due to the crumbling of the citizenry and America’s blubber epidemic. In the U.S., there were 30 actor over age 65 in 2000 (13% of the population) and it is estimated that there will be 54 actor over age 65 in 2020 (16% of the population). Thirteen percent of American adults were adipose in the mid 1960s, compared with 35 percent in 2008.

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The systolic claret burden is the accomplished burden accomplished in the arteries back the affection contracts. The diastolic is the arterial burden back the affection relaxes. They are abstinent in a assemblage accepted as mmHg (for millimeters of mercury). The analogue of accustomed claret burden and hypertension that has been agreed aloft by a cardinal of medical societies is a cardinal of abstracts averaging the following:

• Accustomed claret pressure: systolic beneath than 120 mmHg and diastolic beneath than 80 mmHg

• Prehypertension: systolic 120-139 mmHg or diastolic 80-89 mmHg

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• Hypertension:

Stage 1: systolic 140-159 mmHg or diastolic 90-99 mmHg

Stage 2: systolic according to or greater than 160 or diastolic according to or greater than 100 mmHg

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It is about recommended that best patients with hypertension be advised such that their claret burden charcoal beneath a systolic of 140 and a diastolic of 90. Best patients acceptable account from alike lower numbers afterpiece to the accustomed range. It is additionally recommended that diastolic claret pressures be kept aloft 65 mmHg, because activity beneath this akin can access the accident of some types of stroke, abnormally amid earlier people.

It is not abnormal for bodies to accept claret burden cuffs at home and booty their claret burden regularly. This is to be encouraged, admitting able belt allocation and able belt adjustment are important. Inaccurate readings, both aerial and low, can aftereffect back the claret burden is not abstinent correctly. The accommodating should be instructed as to what admeasurement belt to use and how to appropriately abode the claret burden cuff.

A cardinal of drugs are accessible to amusement hypertension. They use assorted mechanisms of action. Some are acceptable for balmy to abstinent aerial claret pressure; others are aloof for added astringent disease. Some patients charge two or three drugs to ascendancy their claret pressure. Interestingly, studies appearance beneath than 40% of Americans with hypertension accept it beneath control. This is because hypertension is a ache with about no affection for best of its course. It requires a medical assay to analyze and is advised with medications that charge be taken circadian and sometimes blemish affection of life. Some patients are decidedly inconvenienced by accepting to defecate frequently due to a diuretic, by ache due to a calcium approach acquaintance or by abstention or lightheadedness due to an alpha or beta blocker.

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Stress from assignment and added situations can access ones claret burden and your retirement may be allowance to lower your claret pressure. Changes in diet, weight accident and exercise accept additionally been accepted to lower ones claret burden and abatement the charge for hypertensive medication.

I cannot allege anon to your situation, as I do not apperceive so abounding factors such as your age, height, weight and all-embracing health. It is accessible for a being with balmy hypertension on a balmy to abstinent claret burden medication to ability a advantageous claret burden by alteration some factors in his or her life, such that claret burden medication is no best needed. This should alone be done boring and beneath a physician’s supervision. It may be that blurred the dosage or switching to a milder medication is ultimately appropriate for you. I would be cautious, as your physician appears to be, and not stop “cold turkey.”

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