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Do I need to anti-hypertensive drugs all my life?

Q: I am 32 years of age. I was diagnosed as a hypertensive patient some 10 years back and have been taking Enam (1 tab daily in the morning) since 10 years. I am a smoker and earlier used to take 10-12 cigarettes per day. Now it is 5 per day. My BP, after Enam used to hover around 130/90. Kidney functions were normal. Echocardiogram was done which showed very mild left ventricular hypertrophy. I shifted to Mumbai 7 years back and was continuing Enam. During a review last year, I was advised to take Enam and Aten 50 in the morning for 2 months. Then I continued with Enam. During a more recent review (reason: palpitations) echocardiogram was done and there were no further anomalies detected. Left ventricular hypertrophy was same as earlier (mild). Cholesterol, blood sugar, lipid profile reports were all fine; T3,T4 and TSH too were ok. My medicines were changed from Enam to Aten-50, 1 tab/day. BP was around 135/100. Smoking is 3-4 per day. I had heard that Enam is a drug I will have to take throughout my life? Is Aten 50 a good drug for me?

A:The aim of treating hypertension of all severities is to prevent long term complications like heart attack, brain stroke, heart failure and kidney failure. These catastrophes are best avoided and prevented by maintaining the BP around 120/80, preferably lower. This level is possible by a holistic approach, diet and non drug methods (low salt, plenty of fruits and vegetables, regular exercise, alcohol in moderation). These methods can reduce BP by upto 20 mm Hg. Additional drugs are often required. ACE inhibitors (enalapril, ramipril etc) are better than drugs like atenolol. In addition of drugs of the group Statin (Atorvastatin, Simvastatin etc.) are also indicated irrespective of lipid profile. Doses and follow up is always recommended under medical supervision.

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