When should we change our blood pressure meds? Taking blood pressure medication is part of daily life for many people. But over time, your needs may change. Here are 7 clear signs it might be time to talk to your doctor about switching or adjusting your treatment.
1. Your blood pressure is still too high
The goal for most adults is to keep blood pressure below 120/80 mmHg. If your readings are consistently above that, even with medication, it may not be working well enough. Around 1 in 4 adults on treatment still have uncontrolled blood pressure.
2. You have side effects that are hard to live with
Up to 30% of people on ACE inhibitors report a persistent dry cough. Calcium channel blockers can cause swelling in the ankles in 10 to 20% of patients. Side effects like dizziness, fatigue, or sexual dysfunction are common reasons people stop taking their meds.
3. Your blood pressure drops too low
If your systolic pressure (top number) is often under 90 mmHg, you may feel faint or lightheaded. This may mean that you need a change of blood pressure meds. Low blood pressure (hypotension) increases fall risk, especially in older adults, where it leads to 1 in 3 serious falls.
4. Your health or lifestyle has changed
Losing as little as 10 pounds can drop your systolic blood pressure by 5 to 10 mmHg. Starting regular aerobic exercise may lower your numbers by 4 to 9 mmHg. These changes may mean you no longer need the same dose or type of medication.
5. You’re taking new medications
Common drugs like NSAIDs, decongestants, antidepressants, and birth control pills can raise blood pressure or interfere with how your current meds work. More than 40% of adults take multiple medications, increasing the chance of interactions.
6. There are better options available
There are over 15 classes of blood pressure medications, with dozens of individual options. Newer combination pills can simplify treatment — one pill can replace two or even three drugs. Studies show that fixed-dose combinations improve adherence by up to 25%.
7. Your life stage or goals have shifted
Some medications, like ACE inhibitors and ARBs, are not recommended during pregnancy. In older adults, aggressive blood pressure lowering may increase fall and cognitive risks. For people over 65, guidelines recommend adjusting medications to balance risks and benefits.
How to bring it up with your doctor
Track your readings for at least 1–2 weeks. Write down side effects and how they affect your daily life. At your next appointment, bring this info and ask whether a different medication, dose, or plan might be better for you.
Sources
American Heart Association. Managing high blood pressure medications
Healthline. Which Blood Pressure Medications Should You Avoid?
