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How to Cut Back on Blood Pressure Medications

Lifestyle really can make a huge difference in many conditions, especially hypertension. Losing weight can reduce the need for blood pressure medications.

Many people are put on blood pressure medications for a lifetime, even if conditions change. This reader lost significant weight and no longer needs two drugs to control hypertension:

Q. I’ve been taking both lisinopril and metoprolol for years to keep my blood pressure under control. Thankfully, I’ve had no side effects from either one.

I have now lost 25 pounds and as a result my blood pressure has dropped to 98/60. Hooray for diet and its benefits for health!

As a result, my doctor is ready to have me taper off the drugs. She said I could choose which one to drop first. Does it matter which one I stop first?

A. Since your doctor has given you the choice, you might consider gradually reducing your dose of metoprolol. This medication is a beta blocker. Although beta blockers like atenolol, propranolol and metoprolol have long been used for irregular heart rhythms as well as hypertension, they are no longer considered the first or even second choice for controlling blood pressure.

A review of blood pressure medications by the esteemed Cochrane Collaboration concluded:

“Beta-blockers are not recommended as first line treatment for hypertension as compared to placebo due to their modest effect on stroke and no significant reduction in mortality or coronary artery disease.”

Side Effects from Beta Blocker Blood Pressure Medications:

  • Disturbed sleep, nightmares
  • Fatigue and lack of energy
  • Psychological depression
  • Dizziness, drowsiness, lightheadedness
  • Itchy skin rash
  • Asthma, breathing difficulties
  • Cold hands and feet
  • Slow pulse

Do Not Stop Beta Blocker Blood Pressure Medications Suddenly:

No one should ever stop a beta blocker suddenly! Doing so could trigger chest pain (angina), irregular heart rhythms (arrhythmias) or at worst, a heart attack.

Some Reports from Readers:

Susanne shared this experience:

“My physician took me off Lopressor (metoprolol) all at once and increased my losartan to 50 mg twice a day. Was this the correct thing to do? I had to go to ER with rapid heart beat and high blood pressure.”

We would say that was not the right thing to do!

Josie wrote:

“My family doctor recently told me to stop taking my beta blockers and without consulting my cardiologist. Today I went for a bike ride. Now I have a very heavy feeling in my chest and it is causing a lot of pain. Could this be caused by going off my beta blocker?”

We advised Josie to call her doctor immediately and have this checked out!

Peppy offered this scary experience:

“My doctor had me taper off metoprolol over two weeks. I don’t think that was slow enough as I got the worst migraine headache that would not go away plus a rapid heart rate. My blood pressure went up! Scary!

“They had a hard time getting that headache stopped. A friend of my sister’s had the same headache experience when they stopped her metoprolol.

“This stuff is nothing to mess with, from my experience. The doctor told me there is a ‘rebound effect.'”

Our Guide to Blood Pressure Treatment has information on the pros and cons of several different kinds of blood pressure medications. You will learn more about the benefits and risks of lisinopril and other ACE inhibitors like benazepril, captopril, enalapril, fosinopril, quinapril and ramipril. It can be downloaded for $2 from our Health Guide section.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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