Beyond the Myths – Control Blood Pressure Effectively!

Hypertension, a commonly heard term, is a mantra for many patients. The impact of hypertension on health is significant, with 41% of total worldwide deaths each year attributed to hypertension and related cardiovascular diseases.

To effectively control blood pressure when diagnosed with hypertension, it’s crucial to use the right methods. However, in clinical practice, many patients hold misconceptions about hypertension treatment, significantly affecting their management. Here are some of the most common misconceptions about hypertension. Have you fallen into any of these traps?

Misconception 1: It’s okay for older people to have slightly high blood pressure.

Many people mistakenly believe that as one ages, an increase in blood pressure is a natural phenomenon. They think that the older one gets, the higher the diagnostic criteria for hypertension become. This misconception is particularly prominent among the elderly population, leading to incorrect diagnosis and ineffective treatment of hypertension.

The diagnostic criteria for hypertension are a systolic blood pressure greater than or equal to 140 mmHg and a diastolic blood pressure greater than or equal to 90 mmHg. Blood pressure above this standard should be treated.

Misconception 2: You can’t stop taking blood pressure medication once you start, or you’ll become dependent on it.

The harm of hypertension is a long-term, silent process, gradually damaging blood vessels throughout the body and affecting vital organs such as the heart, brain, and kidneys. The earlier blood pressure is controlled at an appropriate level, the better the protection for blood vessels, preventing serious complications such as heart attacks, heart failure, stroke, and kidney failure.

Apart from mild hypertension in the early stages, which can be controlled by adopting a healthy lifestyle, other types of hypertension should be treated with medication as early as possible.

Misconception 3: Blood pressure medication has side effects and dependency; if you can avoid taking it, you should.

All medications have side effects, but their impact is not severe and is manageable. Refusing to take medication can lead to greater harm than the side effects caused by medication. Therefore, the benefits of taking antihypertensive drugs outweigh the drawbacks.

Antihypertensive drugs are not addictive; they do not cause dependency. The reason hypertension is considered a lifelong disease requiring lifelong medication lies with blood pressure itself, not with antihypertensive drugs.

In general, antihypertensive drugs should not be stopped casually because once discontinued, blood pressure may rise again, or even rebound, leading to an increase in blood pressure. This phenomenon can be understood as not the drugs being addictive, but hypertension having a “dependence.”

Misconception 4: You can stop medication once your blood pressure is normal.

The treatment of hypertension requires consistent medication to maintain stability. While hypertension cannot be cured, it can be controlled through comprehensive treatment. Abruptly stopping medication can cause blood pressure to rise, and excessive fluctuations in blood pressure can cause more severe damage to multiple organs in the body.

The correct approach is to maintain blood pressure control for an extended period (generally six months to a year), gradually reduce medication under the guidance of a doctor, and control lifestyle factors while continuously monitoring blood pressure.

Misconception 5: You should take medication when blood pressure is high and stop when it’s normal.

Over 95% of hypertension cases are “primary hypertension,” which can only be controlled, not cured.

This means that when hypertension patients refer to their blood pressure as “normal,” it’s only a state achieved through medication. Since the effects of medication are temporary, once discontinued, the effects disappear, and blood pressure rises again. Therefore, antihypertensive treatment must be continued, and self-discontinuation is not recommended.

Misconception 6: If you don’t feel any symptoms, you’re fine and don’t need medication.

The most common symptom of high blood pressure is headaches, dizziness, tinnitus, insomnia, etc. However, each person’s symptoms vary, and some may have no symptoms at all. But the absence of symptoms doesn’t mean there’s no problem; there’s no clear relationship between blood pressure levels and the severity of symptoms.

The lack of symptoms may be due to the long duration of the disease, leading to adaptation to the symptoms, which is even more dangerous. Therefore, whether or not hypertensive patients experience discomfort, the harm caused by high blood pressure persists and cannot be determined solely by feelings.

Misconception 7: You shouldn’t start with effective medication; otherwise, there won’t be any left later.

Lowering blood pressure is the core function of antihypertensive drugs; any drug that can effectively lower blood pressure is a “good drug.” If there is a need to distinguish between “good and bad,” the reason “good” antihypertensive drugs are considered good is that they can provide additional protection to vital organs such as the heart and brain, not because using these “good” drugs precludes the use of other antihypertensive drugs.

Misconception 8: Long-term use of antihypertensive drugs will lead to “drug resistance.”

Indeed, some individuals find that after many years of taking antihypertensive drugs, their previously well-controlled blood pressure becomes unmanageable. However, this is not due to the body developing resistance to antihypertensive drugs; it is mostly due to poor lifestyle management or further elevation of blood pressure due to aging. In such cases, improving lifestyle habits and adding other medications can address the issue, rather than spreading fears of “drug resistance.”

Misconception 9: Antihypertensive drugs need to be changed every few years.

Many patients spend their lives seeking the “best” medication, even blindly following others’ use of supposedly effective drugs. This is highly incorrect and dangerous. Every patient’s condition is unique, and the suitable medication varies. Each antihypertensive drug has its rationale for existence. The determination of a drug’s quality isn’t based on its price or others’ experiences but on its suitability for the individual.

As long as the antihypertensive drug effectively controls blood pressure without causing side effects, it is the “best” medication and should be continued. Regularly switching medications is not recommended unless there is a significant advantage in efficacy and side effects with a new drug, under a doctor’s guidance.

Misconception 10: Blood pressure must be lowered as quickly as possible, and the lower, the better.

Except for hypertensive emergencies, antihypertensive treatment should proceed slowly and cautiously. Rapid and excessive lowering of blood pressure carries a significant risk of hypotension, potentially leading to fatal consequences. It’s reasonable to take 2 to 3 months from hypertension diagnosis to achieving blood pressure control.

For ordinary hypertensive patients, blood pressure should be lower than 140/90 mmHg; for high-risk patients with diabetes or kidney disease, it should be lower than 130/80 mmHg; for patients with cerebrovascular or coronary artery disease, it should be lower than 130/80 mmHg. However, lower blood pressure isn’t always better because excessively low blood pressure can lead to inadequate cerebral blood flow, increasing the risk of cerebral ischemia.

Misconception 11: Relying Solely on Medication without Monitoring Results

The treatment of hypertension is not a one-size-fits-all approach, as individuals vary in their sensitivity to medications. It’s essential to regularly monitor blood pressure to observe the effectiveness of treatment.

Long-term, consistent monitoring and recording provide clinical evidence for understanding the relationship between medication use and blood pressure changes, facilitating adjustments in medication dosage and types.

In addition to regular monitoring, individuals with cardiovascular diseases should prioritize lifestyle improvements. This includes adopting a low-salt diet, maintaining balanced nutrition, controlling weight, quitting smoking and limiting alcohol intake, engaging in moderate exercise, paying attention to sleep quality, and maintaining psychological balance.

Misconception 12: Health Supplements Are Side-Effect Free and Better Than Blood Pressure Medication

All individuals with hypertension need to understand that currently, no medication or device can cure hypertension. Therefore, any claims made by supplements, health equipment, or other “miracle cures” promoted in various settings and media to cure hypertension are false advertising.

The hypotensive effects of these health supplements have not been scientifically validated through clinical trials. Not only is it a waste of money to use them, but they may also pose health risks. Even in the absence of harm, they can delay proper hypertension treatment. Hence, it’s crucial to follow medical advice and take prescribed medications properly to truly treat hypertension.

Misconception 13: Antihypertensive Medications Can Be Purchased Over-the-Counter

Hypertension has many types, and the choice of treatment medications varies for each type. Medications should be used under the guidance of a specialist doctor. The selection of antihypertensive drugs not only targets blood pressure control but also considers the protection of other organ functions in the body.

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