doctor taking blood pressure reading, blood pressure high, misdiagnosed with hypertension

Every one knows the dangers of hypertension. We are repeatedly told that the “silent killer” leads to heart attacks, strokes, kidney disease, blindness and dementia, to name just some of the scary consequences of uncontrolled high blood pressure.

What we are not told, however, is that aggressive treatment with medications may also pose risks. A new study in JAMA Internal Medicine (online, Feb. 24, 2014) found that older people treated with moderate to high-dose antihypertensive medications were at 30 to 40 percent increased risk of dangerous falls.

Nearly 5,000 Medicare beneficiaries were tracked for three years. Most (86 percent) were taking at least one drug for high blood pressure. Nearly one third were taking two or three different kinds blood pressure pills simultaneously. Older people who fell experienced joint dislocations, hip fractures and major head injuries. In many cases these accidents led to disability or even death.

One reader shared her own experience:

“I am taking amlodipine (Norvasc), carvedilol (Coreg) and losartan (Cozaar) for high blood pressure. These drugs have me feeling bad. Last September I fell and completely passed out. I had a broken pelvis, broken rib and a concussion. I was hospitalized and had to spend two months in rehab. If this happens again it is curtains for me.”

A fall like this is a red flag for another accident. The researchers found that the risk for a second serious fall more than doubles in patients taking multiple blood pressure medications.

Balancing the benefits of blood pressure medicine against their risks is a delicate proposition. That is why new guidelines for treating high blood pressure have raised the bar. Instead of aiming for 140/90 in those over 60, experts have determined that physicians should only treat hypertension when the upper number (systolic blood pressure) exceeds 150 (JAMA, Feb. 5, 2014).

As long as side effects such as dizziness, drowsiness or unsteadiness are not a problem, the benefits of treatment may well outweigh the risks. When people find that their quality of life is affected by their medicine, however, they may need to discuss their treatment program with the prescribing physician.

Another reader shared this experience with a beta blocker blood pressure drug:

“I have been on metoprolol for years and before that it was Toprol. I have asked numerous doctors why I have experienced so many symptoms. I’ve had fatigue, depression, palpitations, dizziness, difficulty breathing, coughing, cold feet and hands, light headedness, poor coordination, and many other problems. I have asked a number of doctors to change my blood pressure medicine but they all seem to just laugh it off. Am I wrong in wanting to change?”

Beta blockers like atenolol, metoprolol and propranolol can cause such symptoms. The new blood pressure guidelines specifically reserve beta blockers for the last line of therapy, only after other approaches have failed. Never stop such drugs suddenly, though, as doing so can trigger chest pain, irregular heart rhythms or even a heart attack.

For other ways to control hypertension, including many non-drug options, we offer our book, Best Choices from The People’s Pharmacy (online at

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  1. Jennie Mc
    South Carolina

    After a year on Lisinopril, I ended up in the ER with severe angioedema. My doctor was convinced the angioedema was caused by a hip injection I had that day, but changed me to Norvasc (amlodipine) anyway. I began to have side effects, especially edema, from that medication after taking it about 2 years. Note that my blood pressure remained in the 145/90 even while on the medication. The doctor added chlorthalidone 25 mg. to help with the swelling. Just this summer, I began to have severe swelling in my feet, ankles, lower legs and hands. I had to keep my feet and legs elevated most of the time. My doctor increased my Chlorthalidone to 50 mg. and continued me on the amlodipine and basically said I could deal with some swelling or risk having a stroke. My blood pressure was still in the high range. Taking matters into my own hands, I discontinued the amlodipine cold-turkey, took 25 mg of chlorthalidone only each day (not the 50 mg. the doctor had increased it to) and in two days my blood pressure dropped to 120/77, and the leg/feet/ankle swelling was gone. My blood pressure continued to drop so I now take the 25 mg. of chlorthalidone only every other day. After a 6 weeks, my blood pressure now averages 105 to 115 /60 to 65 and I have no swelling. I also take a tart cherry juice capsule every night before bed. I’m sure my doc will be livid at my next visit. I think doctors can overprescribe medications! Back in the “old days” a diuretic was the first and only, medication prescribed for HBP. Just remember though – your mileage may vary.

  2. Kay

    Is it possible with some people such as myself, who are very sensitive to meds, to be over-treated with blood pressure meds?

  3. Kay
    san antonio

    I want to lower my dose of lisinopril, but blood pressure at dr office is usually up too high. Doctor wanted me to go on Amlodopine for first time , but it was too expensive. He sent Clondine to have on hand in case I needed it. After one pill I was up most of the day and night, having serious shortness of breath and weakness. I want to get off these meds. I didn’t need them 7 years ago when I first got them. I was coming out of a severe emotional crisis, and I had hypertension. I also take a small dose of alprazalam when needed. Don’t trust pills!

  4. Paula
    Vernal Utah

    My husband has taken med for high blood pressure for at least 10 years and he has all those symptoms he has fàllen but not regularly he is dizzy tired and grouchy depressed I’m wondering if his meds are what is causing him to be sick!!

  5. Mike

    At the end of the day, you are responsible for your health and meds. My well-intentioned doc has been trying to put me on blood pressure meds for 5 years. I have made lifestyle and diet changes. I take my own blood pressure for a few weeks before my annual to compare to his one time reading that may be affected by white coat syndrome.

    I always have come up with an acceptable range for him. The last time he had some strange viewpoint about my readings and got a lot pushier. We came to an agreement about more closely monitoring. You know how you feel and you can do as much research as your doctor. You can value his opinion but should value yours more. I have seen to many seniors get on a rapid downward spiral of med after med after med. I happy to live an active 15 more years active and med free as opposed to 25 more years in a med haze.

  6. Steve

    Some History:
    I was prescribed Lisinopril 5 months ago from a random Doc. (I have no regular Dr.)and given no information left assuming it’s a magic pill. I am 52 5’10 190lbs and intensely active now, but then, I was coming off of 2 years of detoxing from an anti-anxiety medication. The detox spiked my BP and I can only assume the 2 years of essentially no activity played a part. Now I have an unbearable cough disrupting sleep and work.

    Is there anyone that’s successfully managed their BP through strictly diet and exercise eliminating meds all together? I’ve done the food research (what to eat/not to eat), I do not smoke or drink. I’ve tested the diet plan waters with some success with the occasional red meat and cheeses not recommended with so,e success, but at times my BP spikes to 160s/100s but is often 110esh/80….I cannot function from the side effects of the meds! Thanks in advance!

    • Pam

      Talk to a cardiologist or family doctor right away. Coughing is one of the side affects of Lisinopril. I was on it for several years, and started coughing after a year on it. It took another 6 mths before 2 of my doctors came to the same conclusion at the same time that it was the Lisinopril. It helped right away once I discontinued it, but my main doctor put me on a different medication to compensate. Don’t stop taking Lisinopril without your doctor’s advice.

    • Kay

      Yes, I have come to that conclusion!

    • Diane
      Raynham, MA

      Maybe do research on hawthorn berry, but you need to wean yourself off the high blood pressure meds first.

  7. sherry

    been on Diovan for almost 4 years 320 milligrams daily since I’ve had the flu and bronchitis the last few weeks I’ve had to stop taking it it was lowering my numbers too low what are your thoughts on this discontinuing my meds really afraid if I take it now my blood pressure is going to go too low

    • Beth

      Please go to a pulmonary doctor, don’t wait as some bp meds may affect your lungs, needing to be adjusted or switch I had to switch.

  8. Rodica

    Aggressive treatment of BP for elderly is dangerous and I know it from the mental decline of my husband which is kept overmedicated by doctors and can’t free himself because he is hypochondriac, obsessed with his BP and has anxiety. Amlodipine or any similar are, from his experience the worse in matter of mental decline and from his behavior it could be even addictive ! I’m loosing my husband to Amlodipine and others BP medications, because he also lost his appetites and is loosing weight ?!

  9. ALICE

    I’ve stopped taking my bp meds daily. I alternate days between diovan and doxicsosin so that I can wean myself off entirely, I seem to feel better when I don’t take any meds I’m 93 and still drive. My lab reports seem fine. My energy level is low. I really would like to stop my bp meds and I think I will function even better.

    • The People's Pharmacy

      Just make sure that you let your doctor know what you are doing and why. Check to see that your blood pressure doesn’t go sky high.

  10. Eva P.

    I recently got put on two new blood pressure meds, and I think they’re too much for me as my blood pressure has been steadily rising all afternoon. My last reading was 185/85 67 about 8:20p this evening. It scared me so much that I took a 325mg aspirin. I had one doctor, then got switched to another doctor this past Tuesday who changed my prescriptions to stronger ones. The young woman who took my blood pressure this last time didn’t take it right; she left my arm dangling, etc., causing me to get a higher reading that I should have. I also have white coat hypertension, and I think the doctor is treating an incorrect blood pressure, instead of my actual blood pressure. I feel like the doctors are trying to kill me with meds!

  11. Barb
    New Mexico

    I feel my initial experience with blood pressure control nearly cost me my life. I don’t remember the name of it, but it caused my pulse to go dangerously low. I had also been put on Lisinopril and Amlodipine. I was barely able to drive myself to the ER, where at the same time my blood pressure was higher than it had ever been. I was treated and taken off the one that lowered my pulse, but kept on the Lisinopril and Amlodipine. My physical condition became unbearable. I was coughing and nose running day and night uncontrollably. I could hardly walk and had to use an electric cart to get my groceries.
    I went off all medications and went to a new ER, and the doctor suggested I had been treated too aggressively for hypertension.
    Since then, I have been trying to improve my diet, and health and take beets or beet juice powder, tomato juice, such as V-8, with lycopene in it. I also found that supplements such as Hibicus, Hawthorn berries, Olive Leaf, Coleus Forskolii, Hops, Pomegranite and others keep my BP within an exceptable range, according to this new report. But, with the caveat that one does have to be consistent, and face the ongoing issue that although “controlled”, I do and will continue to have hypertension that must be watched and dealt with. But thankfully, I do not have to take blood pressure medication. I had been made paranoid previously if my blood pressure got over 140/90.

  12. mmv

    Years ago, my doctor insisted I had high blood pressure and put me on Verapamil. He decided this after taking one reading at one office visit. At the time, I had been using Sudafed for repeated bouts of sinus congestion. He never asked if I was taking any medication; over the counter or otherwise. My pressure at that visit was 154/92.
    Once my sinuses cleared and I stopped the Sudafed, my BP went back to its normal (for me) 90/60 and I stopped taking the Verapamil. He is no longer my doctor. We need to be more diligent in orchestrating our own medical care. I know doctors are very busy and can easily make a mistake. Since that time I make a point of asking questions, repeating back what I hear to be sure and if the doctor gets upset with me I ask for my records so I can find someone that will take the time to explain my care to me.
    Your programs encourage me to ask the questions. The answers may lead to different approaches and I also think my current doctor appreciates that we can speak openly about my care.

  13. RM

    My father lived to be 92. The last months of his life he took high blood pressure medicine. He had a number of falls after that. He took several different medicines and they all had some side effects.
    The Doctor had put him on baby aspirin some years earlier, & eventually after quite some time he developed ulcers. He never recovered from the ulcers. Later I gave him fish oil several times a week to thin his blood.
    Today, looking back I think he would have been better off without any of the medications, except the lasik. (not sure of the spelling) He began a rapid decline after he first started the lasik, losing a lot of weight.
    They finally reduced the dose which made it barely tolerable. They also had him on antidepressants for a while, possibly to help him sleep. These would cause constipation when taking them.
    The doctors never mentioned and probably didn’t know that it takes a full six months to wean yourself off this medicine, otherwise you won’t be able to sleep and will have panic attacks when you stop.

  14. Torrence

    I have been on just about every BP meds there is and found out I don’t even have high blood pressure. HOW? I was taking 1mg of CLONIDINE daily at night. Before I started this pill I was a waker almost every day. One day, at the Mall, I almost passed out and thought I was having a heart attack. It turns out the pill was making my BP so low it was causing the problem. The doctor told me to just take a half of pill. I still could not walk like I did before the pill. The I went to just a quarter of the pill on my own and found out it still had a small effect on me. BUT, I went to the doctor for a follow up. At this time I was taking the quarter pill every other day My wife was first before me to see the doctor. So, I was in the waiting room for over an hour.
    When I went in my BP was checked and it was 122/80. So, I decided that my BP most of the time was WHITE COAT at the doctors. I have quit the pill all together and NOW I don’t get fainting spells when I exercise. A quarter of a pill like that is nothing, so I decided if it [the quarter] was still lowering my BP to far, I didn’t need it at all. I like the idea of 150/90 BP. I can live with that and will cut back on salt and make sure I do my exercises. THINK ABOUT IT!

    • Ann

      Torrence, FYI since you didn’t post your age but clonidine should not be given to elders over the age of 60 at least not on a regular basis. You can find this information in the Beers report..

  15. rh

    My sister has slightly elevated blood pressure that became much higher each time it was taken in the doctor’s office (White Coat Syndrome.) He threatened to put her on blood pressure medication but she was refusing.
    I am an RN and have repeatedly advised her not to take any medication that is not 100% absolutely necessary. I sent her the article from The People’s Pharmacy regarding eating beets to reduce blood pressure. She has been eating a serving of beets daily for the past several months and monitoring her blood pressure at home. After eating the beets for about a week, she reported to me that her blood pressure returned to normal and stays that way as long as she eats the beets.

  16. Rodica

    I think is wars than what you mentioned for older people. My husband who is now 72 was put on Amlodipine-Norvasc some 4 years ago and since then he is going down mentally and got among a lot of others negative effects of that drug, some v. strange ones like becoming uncaring, losing feelings and sensibility and of course confusion, being unfocused and irrational. And even worse, it looks like this drug, (v. cheap made in India) has addictive power because my husband, obsessed and hypochondriac believe that only this drug is really working for him and never really reported his side effects which are gradually and v. subtle ?!
    In order to be kept on it even some honest doctors tried to replace it he boycotted the new ones and pretend that it make him sick ?! The same think with the supplements, I tried to convince him would be the best option. As somebody already mentioned the doctors basically ignore and don’t care about side effects that would be a conflict of interest for them and whoever manufacture the drugs. He is sort of brain washed and educated to blindly trust doctors and don’t dare to question and challenge their decisions ?!

  17. frenagd

    Yep, I used to have a care home and we hated it when doctors wanted to change meds on one of our elders, because we knew we’d be picking them up off the floor. Family members need to be very pro-active on this issue. I used to personally negotiate with people’s doctors over whether a new med would cause more problems than it was supposed to fix…..

  18. Brooks

    Are the symptoms the result of low blood pressure or the effect of the medicine?

  19. Jan S.

    I have had neuropathy for some years and when balance became really bad, at age 77, this was expected with PN. But your newspaper article and this one make me wonder. Dr’s seem thrilled when they see 115/68 or lower but I am sleepy all the time, no energy, seriously having trouble with balance, already over a year ago, asked the dr. to cut my Rx (Cozaar), in half… and felt much better. Maybe it’s time to lower it again. I also take Cardizem for my heart. Thanks for this article; I will ask about it.

  20. et

    My husband is 89 yo. on atenonol for 14 years. Was put on enalopril high doses along with atenonol for chest pain, that went away. Now six years later after adding the enalopril, my husband is falling in house, sleeping all day, up at nite, and memory confusion. Doctor will not admit that any medication will cause this. Also had him on high dose statin, until it was pulled off market and said he would not take him off unless he got the notice. It is impossible to change his doctor at this age. What is a person to do?

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