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BP spike and Losartan

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No chronic illnesses. Generally healthy and active. occasional BP at 138/90 max. Dr prescribed Losartan (50mg once per day). Past two days have had weird spikes over 30-60 minute periods of BP up to 160/95. NEVER had this before - no change in diet. I want to get off Losartan before my body adopts it too much. Is it safe to go off it now and watch my BP closely?? - doctor appt scheduled for Tues. By the way, resting heart rate normally pre-Losartan is 122/82. I only started this prescription 2 days ago. Never been on BP meds prior. So this has been two pills (50mg each) that caused this.

Category: Cardiologist

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Category: Cardiologist
 23 Doctors Online

Thank you for your query at

If your blood pressure was never elevated before starting the drug why were you started on the drug at all in the first place? Did you have any symptoms which lead to diagnosis of elevated blood pressure and therefore you were started on an antihypertensive medication? Is your blood pressure elevated only when you visit the doctor and is it normal all the time when you are at home?

Losartan would never by itself cause an increase in the blood pressure. The elevated blood pressure that you are seeing is is your own intrinsic blood pressure rise in spite of the medication and the medication is helping to reduce the blood pressure to some extent.

You may stop the blood pressure medication if you do not have any symptoms associated with the spikes but you need to monitor your blood pressure for accelerated hypertension and excessive rise in blood pressure.

The best approach would have been 3 sets of your blood pressure reading should have been taken at your first visit and after a month another 3 set of readings should have been taken and if the blood pressure was still elevated antihypertensive medications should have been started.

If you feel that your blood pressure is elevated only when you visit the clinic of the doctor then ambulatory blood pressure measurement at home can find out whether you are having white coat hypertension or true hypertension
The body does not get adapted to losartan.

Losartan protect the body from ill effects of increased blood pressure as long as the patient is taking the medication and once you stop the medication the blood pressure rises back to its original level so there is no question of adapting to the drug.

Hope this helps, please feel free to discuss further.
Dr Vivek Mahajan
DM Cardiology

Patient replied :

Thank you - my doctor noticed elevated blood pressure every time I went to visit him over 2 years. That being said, at home my blood pressure is not that bad - so I will continue to take the drug until my appt on Tuesday and monitor my BP at home throughout.

Here is why I thought that the BP spikes were strange. My BP went from 160/90 as a high down to 127/71 at a low. Yet my heart rate at 69 remained the same. I took 10 readings over a 3 hour period. Heart rate never changed. but my BP would spike. I will continue to record and advise my doctor on Tuesday. thank you.

Since you have noticed those elevation over 3 hours at home you may truly be hypertensive. Still a reassessment after 1 month would have been reasonable.
But now that you have been on medications I would suggest that you continue it and maintain a record of bp at home.
It won't harm you.
All the best

Dr Vivek Mahajan
DM Cardiology

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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