Is medication required to correct 140/90 mm Hg blood pressure checked by Holter monitor?

Q. My blood pressure is 140/90, and the doctor prescribed me Telmisartan 20 mg. Should I take it?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Sep 29, 2021 and last reviewed on: Jul 12, 2023

Hi doctor,

I am a 44-year-old of height 5' 7" and my weight is 207 pounds. My blood pressure is 140/90 mmHg, and the ECG was normal, but just chronic palpitations probably due to chronic anxiety. All blood tests are normal. I have TSH - 0.163 mIU/L, S-FT4 - 11.5 mg/dL, S-FT3 - 5.7 mg/dL, Triglycerides is 1.5 mg/dL, S-cholesterol (total) is 4.32 mg/dL, S-HDL is 1.29 mg/dL, S-LDL is 2.81 mg/dL. Note that the ultrasound of the thyroid gland was normal. Blood sugar is 5.3. Slightly elevated liver enzymes but not seriously. I have GAD AND SAD chronic since childhood. My daily medications (permanent usage) under consultations of specialists are Prozac 40 mg, Cabergoline 0.25 mg twice per week, Crestor 10 mg daily, Cialis 10 mg on demand. A doctor added cabergoline and Cialis as an antidote to encounter the side effects of SSRI. I recently did a Holter monitor for 24 hours. Please see the results in the attached file. Do I need medication right now for the blood pressure or not? The GP suggested I start with Micardis 20 mg daily, but I am scared about the sexual side effects and weight gain.



Welcome to

Your blood pressure is mildly elevated. Lifestyle modifications may help reduce it. However, if these measures do not reduce blood pressure in three to six months, then medicines may be started. Measures to control BP (blood pressure) are avoid smoking and other addictions, reduce salt intake in the diet, reduce fatty foods, junk foods, saturated fats, avoid stress and anxiety, do regular moderate-intensity exercise such as brisk walk for 30 minutes, have a proper night's sleep. Should have at least eight hours per 24 hours, including at least six hours in uninterrupted night sleep, reduce weight even if weight is within normal range, drink plenty of water, do deep breathing exercises and meditation. You may also take the prescribed medication along with these measures. If you do not want to take medicine, these measures can reduce blood pressure, but the magnitude is different in different individuals. I hope this was helpful.

Hi doctor,

Thank you. If the blood pressure is still the same after three months, what you think about the medication Telmisartan 20 mg? Is it safe without side effects? And for my reading, is 20 mg sufficient? Kindly give your opinion.



Welcome back to

20 mg is a low dose. If weight reduction and other measures reduce blood pressure, then no need for medicine. If BP is still high after adopting these measures, then take 20 mg once a day initially, and the dose may be increased every three to four weeks if BP is still not under control. Possible side effects are allergic reactions such as lips swelling, rash, etc., or increased potassium in blood in those with deranged kidney function. I hope this was helpful.

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