Just had the conversation with my cardiologist I've been waiting for. After 6 years on lisinopril 20mg for hypertension, I'm officially discontinuing it. My blood pressure has been consistently normal for the last 3 months without it (we did a trial taper starting 12 weeks ago).
| Timepoint | BP (office avg) | BP (home avg) | Weight | Lisinopril |
|---|---|---|---|---|
| Pre-semaglutide | 148/94 | 142/90 | 278 lbs | 20mg |
| Month 2 | 138/88 | 134/86 | 262 lbs | 20mg |
| Month 4 | 128/82 | 124/80 | 249 lbs | 20mg (reduced to 10mg) |
| Month 6 | 122/78 | 118/76 | 238 lbs | 10mg |
| Month 7 | 118/76 | 116/74 | 234 lbs | 5mg (taper started) |
| Month 8 | 120/78 | 116/76 | 229 lbs | OFF |
M/56. The home averages are from my Omron cuff, morning readings before coffee, average of 3 readings per session, 5-7 sessions per week. I take this seriously because my father died of a stroke at 62.
I'm going to continue monitoring daily and see my cardiologist again in 6 weeks. But this feels like a genuine turning point. One less pill.
Well managed taper. A few things I want to highlight for anyone in a similar situation:
- DO NOT stop blood pressure medications on your own. This was done under cardiologist supervision with a gradual taper and close monitoring. Abruptly stopping antihypertensives can cause rebound hypertension which is dangerous.
- The relationship between weight and blood pressure is well-established: roughly 1 mmHg systolic drop per 1 kg (2.2 lbs) lost. The OP lost 49 lbs, which predicts about a 22 mmHg systolic drop — and they got a 28 point drop (148→120), suggesting the semaglutide may have additional direct vascular benefits beyond weight loss.
- Home monitoring the way you're doing it — morning, fasted, averaged, multiple readings — is actually considered more reliable than office readings for diagnosing and managing hypertension.
Given your family history, I'd recommend asking about a coronary calcium score if you haven't had one. It's a cheap CT scan that directly quantifies arterial plaque.
Congrats. Getting off a medication you've been on for 6 years must feel incredible.
I had a similar experience — was on amlodipine 10mg for 4 years, now off it after 7 months on semaglutide. BP is consistently 118-122/72-76. My doctor said the weight loss essentially "cured" the hypertension, though he prefers the term "resolved" since it could come back if weight is regained.
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Shop Reference StandardsThat's exactly the word my cardiologist used — "resolved." He was very clear that if I stop semaglutide and regain weight, the hypertension will very likely return. He also said that the longer I maintain a healthy weight and normal BP, the less likely that is, because the vascular remodeling that happens with chronic hypertension can partially reverse over time.
And yes, I've had a CAC scan — scored 42, which is moderate for my age. Another reason I'm staying on top of cardiovascular health.
This gives me hope. I'm on lisinopril 10mg + hydrochlorothiazide 12.5mg. 4 months into semaglutide, BP is already trending down. Going to discuss with my doc at my next visit about whether we can start reducing.