Do I need to adjust my antihypertensive medication when my blood pressure becomes low in summer?

Every summer, many hypertensive patients take the same dose of antihypertensive drugs and their blood pressure will be lower than in autumn and winter. The reason is that the temperature rises in summer and the peripheral blood vessels of the human body expand, causing the blood pressure to drop. Secondly, In summer, sweating increases and sodium loss increases, which is equivalent to the effect of a diuretic. Sodium loss leads to a decrease in blood volume and can also lower blood pressure.

So, as blood pressure becomes lower in summer, do antihypertensive drugs need to be reduced or discontinued?

First of all, it depends on the extent of the drop in blood pressure. Generally speaking, if the drop in blood pressure is not very large and the patient has no related symptoms, there is no need to reduce the dose. This is because antihypertensive treatment The core strategy is to steadily lower blood pressure. Reduction of drug dosage will inevitably lead to fluctuations in blood pressure levels. As the weather turns colder, blood pressure will rise again, especially for the elderly, as they all have varying degrees of atherosclerosis. , poor blood vessel elasticity, low tolerance for blood pressure fluctuations during drug adjustment, and when the weather turns cold, blood pressure often rises much higher than the baseline level before tapering, resulting in a long period of antihypertensive drug adjustment, high blood pressure Large fluctuations can easily lead to an increased risk of cardiovascular and cerebrovascular diseases. Moreover, most home self-tests of blood pressure are performed during the day. The weather is hot in summer, the days are long and the nights are short. Many people will suffer from reduced sleep quality and lack of sleep, as well as increased sympathetic nerve excitability, which will lead to increased blood pressure at night and early morning. Therefore, low blood pressure during the day does not necessarily mean low blood pressure at night. Especially in the elderly, blood pressure often has nighttime hypertension and early morning hypertension. Nighttime and early morning hypertension are highly concealed and harmful, because increased nighttime blood pressure or early morning blood pressure is a sign of cardiovascular disease. one of the high-risk factors.

For some patients whose blood pressure drops too much or who have intolerable clinical symptoms, the dosage and type of antihypertensive drugs can be appropriately adjusted, and diuretics can be removed from the variety. For example, patients have been taking loxa This single-tablet compound preparation of irbesartan and hydrochlorothiazide allows you to remove the diuretic hydrochlorothiazide and take the single-tablet preparation of irbesartan.

Discontinuation of antihypertensive drugs is not recommended. This is because hypertension has various mechanisms that increase blood pressure, such as increased levels of renin, angiotensin, aldosterone, high sympathetic nerve activation, high-salt diet, obesity, atherosclerosis and other factors that are involved in the increase in blood pressure. High blood pressure is the result of the simultaneous action of multiple factors. Therefore, the reduction of blood pressure in summer does not mean the elimination of these initiating factors, but the weakening of the leading role of some factors. For example, the expansion of blood vessels in summer and the increase in perspiration play a role to a certain extent. It has a blood pressure lowering effect, but as the climate gets colder, blood pressure will continue to rise. And most patients' blood pressure will rise again within a few days after stopping the drug. The medication regimen needs to be reformulated, which will increase the frequency of blood pressure fluctuations and is not conducive to stable blood pressure reduction.

Finally, many antihypertensive drugs are not used solely for the purpose of lowering blood pressure, such as the angiotensin-converting enzyme inhibitors of the priline class and the angiotensin 2 receptor antagonists of the sartan class. In addition to its antihypertensive effect, it also has heart and kidney protective effects. It is a drug that improves the prognosis of patients with coronary heart disease. It should be taken for a long time regardless of whether there is high blood pressure. Similarly, for patients with coronary heart disease and chronic heart failure, beta-blockers such as metoprolol are also drugs that can improve prognosis, prevent myocardial infarction, delay the progression of heart failure, improve survival rate and extend life span, and they cannot be easily stopped. of.

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