Doctor, Can I Stop The Medicines Now?
Patient: Doctor, my BP readings are normal now. Can I stop the medicines?
Doctor: It is excellent that your BP is under control. That means the medicines are working. However, treating a chronic illness is like driving a car. Think of the medicine as the accelerator. As long as you keep pressing the accelerator, the car keeps moving smoothly. If you think you have reached the desired speed and take your foot off the pedal completely, the car will eventually slow down and stop. Similarly, if you stop the medicine, the control is lost, and your BP will rise again.
Patient: But my dosage keeps changing. Sometimes you increase it, sometimes you decrease it. Why is that?
Doctor: That is exactly like driving on a road with ups and downs. When you are driving uphill, you need to press the accelerator more to maintain the same speed. In your body, if there is more stress, infection, or aging changes, we may need to increase the dose (press the accelerator more).
Patient: And when do you reduce it?
Doctor: That is like going downhill. When the car is going down a slope, you don’t need to press the accelerator as much; you might even ease off. Similarly, if you lose weight, eat less salt, and exercise regularly, your body needs less help. In that “downhill” situation, we can reduce the dose. But rarely do we stop driving the car entirely.
Patient: But I feel perfectly fine now. I have no headache or giddiness. Why should I continue?
Doctor: That is the tricky part of High BP. We call it the “Silent Killer” because it often has no symptoms until it causes a major event. You might feel fine on the outside, but inside, the high pressure is silently damaging your blood vessels, heart, and kidneys.
Patient: Is there no permanent cure?
Doctor: As of now, for most people, there is no “cure” like we have for an infection. It is a condition to be “managed” to prevent complications.
Patient: Actually, my neighbour told me that taking BP medicines for a long time will cause kidney failure. Is that true?
Doctor: That is a very common myth, and it is completely wrong. In reality, it is the High Blood Pressure that destroys the kidneys. The medicines actually protect your kidneys by reducing the pressure on them. In fact, for patients with diabetes, we specifically prescribe certain BP medicines to save the kidneys.
Patient: Are there any natural or herbal medicines that I can take instead?
Doctor: While natural remedies sound appealing, they are not tested with the same rigour, or strictness, as modern medicine. Hypertension is a serious issue. Relying on unverified herbal powders can lead to poor control. If you want to take supplements, please discuss them with me first so I can check for dangerous interactions.
Patient: These medicines are expensive. I am a pensioner. What can I do?
Doctor: You don’t need to buy expensive branded medicines. There are generic versions that are just as effective and cost a fraction of the price. You can get them from the nearest Jan Aushadhi Kendra.
Patient: One last question. If I have a party and drink alcohol, should I skip the tablet that day?
Doctor: No, never skip your medicine. Alcohol can actually raise your blood pressure, so your body needs the protection even more. However, we should discuss how to limit alcohol intake, as excessive drinking will make your BP harder to control.
Patient: Thank you, Doctor. The car analogy makes sense. I will not stop the medicines by myself.
Doctor: You are welcome. Remember, we are a team. Let us keep the journey smooth.
Dr. Shashikiran Umakanth (MBBS, MD, FRCP Edin.) is the Professor & Head of Internal Medicine at Dr. TMA Pai Hospital, Udupi, under the Manipal Academy of Higher Education (MAHE). While he has contributed to nearly 100 scientific publications in the academic world, he writes on MEDiscuss out of a passion to simplify complex medical science for public awareness.
