Man’s medication may not be needed

Dear Dr. Roach: I am a 65-year-old male. I have been taking hydrochlorothiazide for several years. Due to a glitch with the pharmacy, I ran out of the meds for a week. During the time I was off the medicine, I took my BP five times per day for four days straight. The average of the 20 checks was 125/74. After finally getting the refill, and restarting it, I again took my BP five times per day for four days straight. The average of the 20 BP checks while on HCTZ was 127/71. My blood pressure while on and off the HCTZ look very close. Am I getting enough benefit from taking this prescrip- tion to outweigh any kidney damage? What would you recommend?

D.B.

Answer: It’s very helpful to have this level of detailed information, especially since yours is an unusual situation. The most important information are the readings while not taking the medication. If the readings you have represent the time after the HCTZ has worn off, then it would be unlikely that you would be recommended to start on treatment, since your risk for developing a problem with a blood pressure of 125/74 is low.

It is also remarkable that the HCTZ was not effective at lowering your blood pressure.

Twenty-five milligrams of HCTZ normally lowers the blood pressure by about 8 systolic points and 3 diastolic points in people with high blood pressure; however, it has been shown to reduce stroke risk in people over 65 with hypertension better than some other agents.

I’m not sure you need any medication. You should discuss discontinuing it with your doctor. If you jointly decide that you still need medication, I would consider a different class.

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