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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12816
Experience:  Emergency Medicine and Family Practice for over 26 years
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What is the best way to wean off 50mg Atenolol for high

Resolved Question:

What is the best way to wean off 50mg Atenolol for high blood pressure. During day it runs around 110/58, but at the end of day before going to sleep it is 88/50 and probaly even lower sleeping. I would like to cut back, it worries me the fact that it gets so low.
Submitted: 6 years ago.
Category: Medical
Expert:  IVY MD replied 6 years ago.
You can just go to the 25mg dose. It comes in 25, 50 and 100mg tablets. Since you are taking the 50, just start the 25, and since that is such a low dose you may be able to just stop it after a couple weeks if the pressure is still low. This is good, and means you are eating correctly and have reduced things like salt in your diet and maybe even lost weight to cause you pressure to go down without medication.
Expert:  Family Physician replied 6 years ago.
I would caution you AGAINST weaning and stopping your medication without first discussing this with your personal physician.

There are other benefits of this medication besides lowering blood pressure including control of heart rate and reducing the risk of heart attacks.

Self-adjustment and/or stopping a medication on your own can be dangerous. Please consult with your personal physician before you make any changes in doses of any medication.
Customer: replied 6 years ago.
When I go to the phsician office it is higher. White coat hypertension. I have lost weight, quit smoking and have relieved alot of stress, plus drinking green tea. Those are the changes I have made. I check my BP every day since I have noticed it lower and it is consitently Lower like I said. Resting in evening watching tv it runs. 85/50. I think I should cut back. Is that too low. I have no side effects that I am aware of.
Expert:  Family Physician replied 6 years ago.
I would suggest checking your blood pressure 1-2 times per day at different times. Carefully record the dates and times along with the blood pressure.

With these readings in hand, I would suggest discussing your concerns with your doctor. I would be personally more worried if you were having symptoms such as being dizzy or feeling "faint".

If your readings are vastly different than your doctors, one possible explanation is the accuracy of your home BP monitor. I typically have my patients bring their BP monitor into my office at their next appointment so that we can check their BP with their device at the same time that I check their blood pressure. In a few cases, the patient readings are very inaccurate. You don't want to adjust based on inaccurate readings.

Another option for diagnosing "white coat hypertension" is a 24 hour ambulatory blood pressure monitor. This device is a computerized BP monitor that checks and records your blood pressure automatically throughout an entire day that it is worn. This will allow you to have dozens of readings without you having to do anything (even while you are sleeping). This can document the normal blood pressure (other than when you are in a doctor's office).
Expert:  IVY MD replied 6 years ago.
Family physician, thanks for your input. All good points!
Customer: replied 6 years ago.
What would you consider to be too low BP when resting?
Expert:  Family Physician replied 6 years ago.
I'm sorry for the delay:

There is no single "right" or "wrong" answer to "How low is too low".

A blood pressure this low would be considered too low if it was associated with symptoms. Generally, we don't like BP to go much below 90 systolic (the top number). It is important to understand that it would be important to be sure that these readings were indeed accurate (to exclude the possibility that the machine is reading lower than the actual BP)
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12816
Experience: Emergency Medicine and Family Practice for over 26 years
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