Are You Taking Too Much Medicine?

Good evening all,

A patient asked me today, “isn’t it better to take less medicine?”

What a great question!

There’s so much packed into such a simple question. I mean, what is “medicine”? Is it just a doctor’s prescription? Is it food? Exercise? Vitamins? Supplements?

Why do we even take medicine?

But let’s keep things simple and pluck out one question: why do I need medicine to treat my blood pressure? Can I just do it naturally? (OK, that’s two questions.)

It’s tough not to go down a real rabbit hole here. There’s just so much to unpack about hypertension (high blood pressure). Even defining what hypertension is can be tricky—different organizations define it slightly differently. For the purposes of this discussion, we’ll say that hypertension is a blood pressure reading that is consistently above 130 (on the top or “systolic” number).

Why do we care about blood pressure?

First, it’s very common. How common depends on age, but in the US somewhere between 35% and 45% of people have high blood pressure.

Second, we’re not doing a great job of treating it—only about a quarter of the people with high blood pressure have it under control.

Finally, untreated high blood pressure leads directly to heart attacks, strokes, kidney failure, and other horrific health problems.

The good news is that it’s usually easy and cheap to treat.

Most people can start off with lifestyle changes like the DASH diet and regular exercise, and avoidance of alcohol and tobacco. But a large portion of people will eventually need treatment with medications. In fact, it’s not unusual to need more than one medication to successfully treat high blood pressure.

The questions I get most often are really interesting.

1. “My blood pressure is great since we started the medication. Can I stop it now?”

   1. No, it’s only great because of the medication. You will probably be on medication the rest of your life. If you’ve substantially changed your lifestyle, maybe this can change, so if you don’t like taking medication, that’s a great place to start (under the supervision of your doctor of course).

2. “How can I have high blood pressure? It’s always been normal!”

   1. Well, no one is born with it, right? Everything has to start somewhere. The biggest risk is actually age. The older you are, the more likely you are to have hypertension. Diet, family history, obesity and other factors certainly play a role.

3. Are there any “natural” products that can treat my blood pressure?

   1. This is the most interesting question because it’s a bigger question that it seems at first. I’ll go into detail below.

So are there “natural” ways to lower your blood pressure? When people ask me that they usually don’t mean diet and exercise—usually they mean supplements. But anything you take in order to change something about your biology is “medicine”, whether it came from your pharmacy with a prescription or you bought it off the supplement aisle. If it alters your biology on purpose, it’s medicine.

There are no supplements (despite all the ads you may see) that will help you with your blood pressure, and this is incredibly important. One of the worst scams about this is “sea salt”. People often come to me after being sold very expensive salt by a so-called “alternative practitioner”. Not only is it ridiculously pricey, but salt—whatever its source—raises your blood pressure. One of the best things you can do to lower your blood pressure is to cut back on salt—any kind of salt.

When people rely on supplements rather than a lifestyle changes and medications while under a doctor’s care, they delay their treatment, often leading to irreversible damage. The longer someone has high blood pressure, the more likely they are to have that heart attack or stroke.

So are you taking too much medicine? Maybe. Maybe not. The goal is to get you to good health any way possible. If medicine is needed as part of the treatment, well, thankfully we have great medications that are inexpensive, effective, and well-tolerated.

Stay well.

-pal