Can I stop taking my blood pressure medicine?
Q. After taking 50 milligrams a day of the beta blocker atenolol for several years, my doctor suggested cutting the dose to 25 milligrams, which didn't negatively affect my blood pressure. A couple of months ago, my blood pressure reading was so good that my cardiologist suggested that I see what happened if I stopped taking the medication altogether. For two weeks, I took only 12.5 milligrams a day; my blood pressure stayed at its usual 115/70. On the first day I didn't take atenolol I felt "buzzed," like I had drunk eight cups of high-caffeine coffee. Over the next week my pressure began to creep upward. On the eighth day, my blood pressure was 133/82 and my heart rate was 96. That was enough for me — I started taking the atenolol again. Did I bail out too quickly?
A. Beta blockers dull the body's response to messages from the sympathetic nervous system. This is the part of the nervous system that makes your heart race when someone startles you. Beta blockers slow down the heart and reduce how forcefully the heart squeezes. They work outside the heart, too. The "buzz" you noticed when you stopped taking atenolol may have been your body's normal response to situations that, while on atenolol, would not have made you anxious. This is why some performers use beta blockers to prevent "stage fright."
You said that your blood pressure gradually rose when you stopped taking the atenolol. That's a sign the drug was helping control your blood pressure, and stopping it took away that protection. If you are comfortable taking this drug and it seems to be working for you, stick with it. If you want to try going without it again, add one more step: go from 12.5 milligrams to half of that for a couple of weeks before stopping altogether. Keep a good diary of your blood pressure and heart rate as you cut down and stop. If you see your blood pressure creep upward as the dose declines, then it would be reasonable for you to stay on the atenolol.
Far too much weight is given to single blood pressure measurements in the doctor's office. Home measurements tell you what your pressure is during daily life. Make sure you measure your blood pressure carefully so you and your doctor make decisions on good information, not bad. Don't drink coffee or alcohol (or smoke) for 30 minutes before the measurement. Sit quietly without talking for five minutes, then measure your blood pressure.
— Thomas Lee, M.D. Editor in Chief, Harvard Heart Letter