Why Your Blood Pressure Medication Might Need a Second Look

A prescription written at fifty may not be the right prescription at seventy. Blood pressure targets, side effects, and the drugs themselves deserve a periodic review — not a lifetime on autopilot.

Blood pressure medication is often started and then, years later, simply continued. The dose that was right at fifty-five, when you were heavier, more stressed, and newly diagnosed, may not be right at seventy-five — when you weigh less, eat differently, and stand up more slowly than you used to.

The result is one of the most common and most preventable problems in older adults: overtreatment. A blood pressure that is now too aggressively lowered causes lightheadedness on standing, and lightheadedness on standing causes falls. Falls in older adults are not minor events.

This is the case for deprescribing — not stopping care, but reviewing it. Targets shift with age. Some medications are less appropriate in older adults than others. A thoughtful clinician will revisit the regimen, lower doses where it is safe, and stop what is no longer earning its place.

None of this is a reason to stop a medication on your own. It is a reason to bring the question to your visit: 'I have been on this for years. Is it still the right dose, and the right drug, for me now?'

Good medicine is not permanent. It is responsive.

— Gregory D. Adams, MD