When it comes to blood pressure (BP), over-treatment is becoming all the more common, driven by stricter guidelines based on flimsy evidence. Financial agendas in the healthcare industry also (unsurprisingly) play a significant role in this. While very high blood pressure may warrant immediate intervention with medication, mild elevations are often treated prematurely. I see this happen all the time. What many doctors don't understand is that high blood pressure is often caused by insulin resistance—a condition that is highly reversible within weeks, if only that was promoted more. It’s important though if you do suffer from high blood pressure, to remember that medications should never be weaned or stopped abruptly unless under appropriate medical supervision. And before you start any BP medication, there are three crucial questions to ask your doctor.
1. Is My BP Really Elevated, or Is It Just White Coat Hypertension?
White coat hypertension occurs when your blood pressure rises simply because you're in a doctor's office or clinic. Before jumping to medication, it’s often recommended to get a home blood pressure monitor if your numbers are only mildly high. I usually recommend taking readings in the morning, afternoon, and evening for one to two weeks. Note these down and bring them to your doctor. This will give a much clearer picture of your true blood pressure status and help you avoid unnecessary medication.
2. Is My Home BP Machine Accurate?
It’s surprising how many people use home blood pressure machines without verifying their accuracy. Take your home machine to your doctor’s office or clinic and compare its readings with those taken by your clinician. Are they the same or at least very close? This simple step is rarely done, but it’s essential to ensure you’re working with reliable data before any treatment is considered.
3. What Are the Side Effects and Drug Interactions of the Medication?
Before starting any medication, be crystal clear on potential side effects and interactions. For example, beta blockers like metoprolol can lower your pulse and make you feel weak or dizzy. ACE inhibitors like lisinopril can impair kidney function, especially when combined with certain other medications that also affect the kidneys. Calcium channel blockers like amlodipine may cause leg swelling. And don't get me started on hydrochlorothiazide (HCTZ)—my least favorite BP medication, especially in those over 65! I've seen countless issues, including low potassium levels and severe weakness.
Remember then, asking these three questions can prevent unnecessary treatment and side effects. I talk more about these points in my latest video—click here to watch.
I’ve had lots of success over the years weaning down and stopping many blood pressure pills that are often not needed. Especially when lots of people decide to institute some amazing lifestyle changes that help reverse insulin resistance and bring blood pressure down naturally (I also talk about this in many of my videos, hopefully you’ve been watching!).
Bottom line: Be sure your doctor is not starting pills too early. Starting any new medicine is not something to be done lightly.
Best Regards,
Dr. Suneel Dhand
I like that you get to the bottom of the issue rather than putting a bandaid over it. Blood pressure rising can be stressful and doctors are so quick to start pushing the drugs. Mine is on the high side of normal, and your videos on this topic have calmed me down and given me perspective. I have been doing a lot of research on insulin resistance and changing my diet, because I had symptoms of insulin resistance; I feel more in control of my health and medical decisions. Thank you Dr. Dhand, you have helped me so much, I am really glad that I found your you tube channel during the pandemic, I watch your videos all of the time!
Thank you ♥️