When it comes to addressing lifestyle diseases, tackling them early on is the key to preventing long-term complications, says expert. But what if things don’t improve even after taking the required measures. Many people report high blood pressure issues even while taking medications. Uncontrolled blood pressure on the other hand can affect heart, brain, and kidney function, increasing risk of heart attack, stroke, and kidney failure.
According to the World Health Organization (WHO), hypertension or high blood pressure affects nearly 220 million people in India, yet only 12% of them have it under control. When, despite your best efforts – following your diet, exercising regularly, and taking your medications, your blood pressure numbers are refusing to budge, you need to look deeper.
A Quora user discussed concerns about his blood pressure remaining high despite taking three medications. Experts say resistant blood pressure could be the culprit, a condition that may develop due to lifestyle factors, missed doses, or underlying medical conditions, according to experts.
“Why would my BP still be high even though I take 3 medications for it and I eat healthy and exercise and don’t smoke, but yet it’s still always high?” said a Quora user.
Let’s understand which blood pressure range is considered healthy and which should raise concern.
What is the normal range for blood pressure?
According to the American Heart Association, the normal range of blood pressure in 120/80 mg Hg.
However, if your blood pressure range remains 140/90 mmHg or above, even on medication, it calls for serious attention, says Dr Ali Sher, Consultant- Internal Medicine, Apollo Spectra Hospital, Delhi.
What is resistant blood pressure and why is it becoming common
Resistant hypertension is high blood pressure that does not respond well to even aggressive medical treatment, according to Johns Hopkins Medicine. Hypertension is considered resistant when someone is taking ‘three different blood pressure medications’ at their maximally tolerated doses, one of the blood pressure medications is a diuretic (removes fluid and salt from the body), or the blood pressure remains above your goal.
Such hypertension may only be controlled by taking four or more medications.
What are the underlying causes of resistant hypertension
Dr Subrat Akoury, Chairman – Cath Lab & Interventional Cardiologist and Head, Asian Hospital explains, medicines play a crucial role in managing hypertension, but they alone are not always enough. Patients often forget doses, consume excessive salt, or lead sedentary lives. These habits can reduce the effectiveness of treatment.
Dr Sher delves into the underlying causes behind persistent hypertension.
Inconsistent use of medicines: The main reason of resistant hypertension despite taking medication is inconsistent use of medicines and inadequate dosage. Sometimes, doctors recommend a combination of drugs but people avoid prescription and skip one or two medicines.
Diseases: Very often, comorbidities like kidney disease, diabetes, thyroid problems, or sleep apnea contribute to resistant hypertension.
Lifestyle habits: We can also blame it on lifestyle habits like high salt intake, excessive alcohol, smoking, lack of physical activity, stress, and obesity. These factors can also blunt the effectiveness of medicines.
Dr Akoury says high salt intake through packaged and restaurant foods, obesity and lack of exercise, sleep apnea and chronic stress, excess alcohol or smoking, and other health conditions such as kidney disease or hormonal imbalances could be behind resistant hypertension.
However, resistant hypertension can be managed with the help of a thorough medical evaluation and a series of lifestyle changes.
How to manage resistant hypertension
Dr. Guruprasad S, HOD, Department of Electrophysiology, Gleneagles Hospitals, Chennai says 50% of hypertension patients become non-adherent to their medications within a year, often skipping doses when they feel better or encounter side effects. Even missing a few doses can affect long-term control.
“Many patients with resistant hypertension do not even realize that they fall in this category, because they think they are giving their best, following instructions, eating well, and exercising regularly, which they genuinely do,” says Dr Guruprasad.
The expert says a structured evaluation that considers both lifestyle modifications and emerging medical interventions can help as “managing blood pressure is not one-size-fits-all, it is personal.”
“Patients should not assume that taking pills will solve the problem. Lifestyle modifications like cutting down salt, eating more fruits and vegetables, regular exercise, and stress management are equally important,” says the expert.
Lifestyle changes to manage resistant blood pressure
- Follow the DASH diet (Dietary Approaches to Stop Hypertension) rich in vegetables, fruits, whole grains, and low-fat dairy.
- Reduce salt intake to less than 5 grams a day.
- Exercise at least 30 minutes daily, brisk walking, yoga, or cycling. Maintaining a healthy weight can lower stress on the heart and improve heart health and blood flow.
- Avoiding alcohol, quitting smoking, and limiting caffeine intake also make a big difference.
- Practice stress-management techniques such as meditation and deep breathing can help manage blood pressure in long run.
- Maintain healthy sleep patterns: Establish a proper sleep routine and ensure 7-8 hours of sleep. Try to go to sleep at the same time every day.
- Incorporating practices like yoga and meditation can also aid in blood pressure management, ensuring overall brain and cardiovascular health.
“Various pain medications, anti-depressants and many natural or herbal supplements can raise blood pressure or interfere with your prescribed treatment. It is essential to share a complete list of all medicines and supplements you take with your doctor to avoid these hidden interactions,” says Dr Guruprasad.