Patient: I don’t drink or smoke, but recent job loss and stress have caused my blood pr to 140 and 90 when it used to 112 and 72. My doc wants me to take medicine, but I heard that once I start taking high blood pressure medicine, I’ll have to take it forever. Is that true?
Doctor: High blood pressure (BP) is usually diagnosed by a consistent elevation of BP readings, usually on three separate occasi ons greater than one week apart. Treatment is usually indicated if BP is consistently >140/90. If this elevated BP is a new finding I would recommend a trial of dietary and lifestyle modifications for a period of three months. There are many lifestyle measures that can be modified to lower blood pressure (BP). These include: Weight reduction with a target Body Mass Index of <25; reduced sodium intake <100mmol/day = 2.4g sodium; increased daily physical activity minimum of 30 minutes/day; reduced saturated fat/cholesterol intake, adequate calcium and magnesium dietary intake and adequate intake of dietary potassium approx 90 mmol/d. The DASH diet (Dietary Approaches to Stop Hypertension) has been promoted by the National Heart, Lung and Blood Institute. These modifications may lower your BP and improve stress and anxiety. If after a 3 month period, your BP has not improved, drug therapy is indicated. This is usually lifelong to prevent future cardiovascular complications.