High blood pressure, or hypertension, is one of the biggest risk factors for heart disease. According to the World Health Organization (WHO), it is estimated to affect 128 crore people aged 30-79 years worldwide.

For people who have been diagnosed with hypertension, it is important to manage blood pressure levels effectively, as uncontrolled blood pressure can lead to complications like kidney damage and stroke. Therefore, it is crucial to consult a doctor and keep medications handy, if prescribed. But how do you know whether or not you need blood pressure medications? To answer that, OnlyMyHealth spoke to .

Dr Chaudhary described high blood pressure as a ‘silent killer,’ explaining that it typically does not present noticeable symptoms, especially in its early stages. Many individuals remain unaware of their condition unless they undergo regular check-ups. According to the WHO, an estimated 46% of adults with hypertension are unaware they have the condition.

However, some early signs can include headaches, light-headedness, dizziness, blurred vision, fatigue, or a general sense of tiredness. In some cases, external symptoms such as feeling tired after walking, chest pain, shortness of breath, or nosebleeds due to very high blood pressure may occur.

“Patients often wonder whether they need medication for blood pressure, particularly if it is their first high reading,” shared Dr Chaudhary, adding that while diet and lifestyle changes are essential, medications may be necessary if blood pressure exceeds a certain threshold.

According to the doctor, for most individuals, a blood pressure reading higher than 140/90 mmHg warrants pharmacological treatment alongside lifestyle modifications such as exercise, low-salt diets, meditation, and yoga.

For individuals with additional health conditions like diabetes, chronic kidney disease, or heart disease, the threshold for initiating medication is lower, at 130/80 mmHg.

Other factors that increase the need for treatment include high cholesterol, smoking, a strong family history of heart disease, or the presence of arterial stents. If non-pharmacological methods fail to normalise blood pressure within 3–6 months, medication becomes necessary.

“Ultimately, a doctor evaluates the patient’s baseline health and risk factors to decide the treatment plan and determine the need for medication,” Dr Chaudhary highlighted.

Blood pressure is measured using a sphygmomanometer, which can be manual or digital. Multiple readings on different occasions are usually required to confirm hypertension.

“In borderline or fluctuating cases, ambulatory blood pressure monitoring (ABPM) may be used to record blood pressure over 24 hours. Home monitoring is also advised in some cases to track blood pressure trends,” Dr Chaudhary said.

Regular follow-ups with a doctor are essential to establish a diagnosis, assess baseline investigations, and determine the need for treatment. Ongoing monitoring, whether through doctor visits or home-based measurements, helps ensure blood pressure remains under control and allows for adjustments in treatment if necessary, he concluded.