Newly diagnosed with high blood pressure: the first few weeks
What is normal when starting blood pressure medication, which effects to watch for and how to turn the dose into a habit.
In short
- In the first few weeks the most important thing is to take your tablet every day at the same time, even if you notice no change.
- Some effects are common at the start (dizziness when you stand up, passing more urine with diuretics, a dry cough with some medicines) and are worth mentioning to your doctor.
- Do not change the dose or stop the treatment on your own, even if your readings look good: that is usually a sign the medicine is working.
- If you are asked to check your blood pressure at home, write down the readings and take them to your appointment; your doctor decides any adjustments.
The first weeks on medication for high blood pressure are a settling in period: your doctor adjusts the dose according to how your blood pressure responds, and you build the habit of taking it. The essentials are to take it every day, note any effect you feel and change nothing without asking.
If you have just been diagnosed, this guide helps you understand what is normal, what to watch for and how to fit the treatment into your day without it running your life.
| What will you find in this article? |
What usually happens in the first few weeks of treatment?
It is usual to start with one medicine and review after a few weeks whether your blood pressure has come down enough. Most blood pressure medicines are taken once a day, although many people need more than one to reach their target.
High blood pressure does not usually cause symptoms, so you probably will not notice any difference when you take the tablet. That does not mean it is not working: the benefit lies in reducing the long term risk of problems such as heart attack or stroke. That is why consistency from the start matters so much.
If you would like to understand the condition better, we explain it in high blood pressure, the silent enemy.
Which types of medicine are used and what effects might you notice?
There are several families of blood pressure medicines and your doctor chooses according to your situation. Each family has its own side effects; most are mild and may go away over time, according to MedlinePlus.
| Family | How it works | Effects you may notice |
|---|---|---|
| Diuretics | Help remove sodium and fluid | Passing urine more often at first; dizziness when standing up |
| ACE inhibitors (for example, enalapril or ramipril) | Relax the blood vessels | Persistent dry cough; dizziness |
| ARBs (for example, losartan) | Relax the blood vessels | Dizziness; often used if ACE inhibitors cause a cough |
| Calcium channel blockers (for example, amlodipine) | Relax the vessel walls | Swollen ankles, headache, constipation |
| Beta blockers | Make the heart beat more slowly and less forcefully | Tiredness; now used mainly when others are not suitable |
Some signs are not mild: swelling of the lips, tongue or face, or difficulty breathing, mean calling 112. If you notice something and are not sure how to judge it, read how to tell if a new medicine does not agree with you.
How do you fit the tablet into your routine?
What works best is linking the dose to something you already do every day, at the same time. That way it stops depending on your memory and becomes automatic.
- Choose a fixed moment: breakfast, brushing your teeth or making coffee.
- Follow what the leaflet says about timing: for some diuretics it recommends taking them in the morning so you do not have to get up at night to pass urine.
- If you forget one day, check the "If you forget to take" section of the leaflet and do not take two doses together.
- Get up slowly from bed or the sofa in the first weeks if you feel dizzy.
Before taking any other medicine, supplement or herbal remedy, ask at the pharmacy. Some very common painkillers can raise blood pressure or interfere with treatment: we explain this in can I take ibuprofen if I take blood pressure tablets?
Do you need to check your blood pressure at home?
Only if your doctor or nurse asks you to, and following the routine they give you. Home readings help show how your blood pressure is responding to treatment, but they are not for adjusting the dose yourself.
- Use a validated upper arm monitor and always measure in similar conditions: seated, after a few minutes' rest and without having had coffee or smoked just before.
- Write down the date, time and result, and take the record to your appointment.
- If you get readings much higher than usual, or have a severe headache, chest pain or problems speaking or seeing, seek medical attention.
Habits count too: cutting down on salt and alcohol, not smoking, keeping a healthy weight and being physically active (the NHS recommends at least 150 minutes a week) help control blood pressure alongside medication.
A practical example: Marta, 58, newly diagnosed
Let us take the case of Marta, 58, an office administrator with high cholesterol controlled with a statin. At a check up she is diagnosed with high blood pressure and her doctor prescribes an ACE inhibitor once a day. She feels perfectly well and finds it hard to believe she needs another tablet.
- Marta decides to take both tablets together with breakfast, after checking with her pharmacy that she can.
- She sets a reminder alarm for the first two weeks, until the habit becomes automatic.
- She checks her blood pressure at home as her nurse advises and notes the readings on her phone.
- After three weeks a dry cough appears: she does not stop the treatment and mentions it at her review, where her doctor considers a change.
Marta stays in control of her treatment, with a system that takes her one minute a day.
How can IMA Health help you?
If other treatments are added to your blood pressure medication, having everything prepared makes consistency easier. At IMA Health we coordinate with a specialised pharmacy that prepares your medication by day and time of each dose, we deliver it to your home and we provide personalised follow-up of treatment changes.
Sources
- MedlinePlus: High blood pressure medicines (in Spanish)
- NHS 111 Wales: High blood pressure
- NHS: Side effects of ramipril
- NHS: Indapamide
This article is for information only and does not replace advice from your doctor or pharmacist.