Should I increase the valsartan dose with a BP of 145/80?

Blood Pressure Management with Valsartan

Yes, you should increase your valsartan dose since your blood pressure of 145/80 mmHg is above the recommended target of <135/85 mmHg for home blood pressure monitoring. 1

Blood Pressure Assessment

Your current blood pressure of 145/80 mmHg is:

• Above the recommended home blood pressure monitoring (HBPM) target of <135/85 mmHg 2
• Classified as Stage 1 hypertension based on home readings 1
• Not at optimal control after one week of restarting valsartan therapy

Dose Adjustment Recommendations

Immediate Action:

• Increase your valsartan dose to the next level (e.g., from 80mg to 160mg, or from 160mg to 320mg) 3
• Higher doses of valsartan provide greater blood pressure reductions and help more patients reach their blood pressure goals 3

Expected Benefits:

• With valsartan 160mg, median time to reach blood pressure goal is approximately 8.1 weeks
• With valsartan 320mg, median time to reach blood pressure goal decreases to approximately 6.1 weeks 4
• Higher starting doses enable more rapid achievement of blood pressure control 3

Monitoring After Dose Increase

• Continue home blood pressure monitoring with proper technique:

  • Take readings after 5 minutes of quiet rest
  • Sit with back straight and supported
  • Keep feet flat on floor with legs uncrossed
  • Support arm at heart level
  • Take at least 2 readings 1 minute apart in morning and evening 2

• Schedule follow-up with your healthcare provider in 2-4 weeks to assess response to the increased dose

Important Considerations

• If blood pressure remains above goal after maximizing valsartan dose, adding hydrochlorothiazide may be necessary

  • Combination therapy with valsartan/HCTZ provides more rapid and effective blood pressure control than monotherapy 4, 5
  • With valsartan/HCTZ combination, median time to reach goal decreases to 2.1-2.6 weeks 4

• Lifestyle modifications remain important alongside medication adjustment:

  • Follow DASH diet rich in fruits and vegetables
  • Restrict sodium intake to <1500 mg/day
  • Engage in regular physical activity (90-150 minutes/week)
  • Maintain healthy weight
  • Limit alcohol consumption 1

Caution

• Monitor for potential side effects after dose increase, though valsartan is generally well-tolerated with low discontinuation rates due to adverse events 4, 5
• Common side effects may include headache, dizziness, fatigue, and palpitations 5
• Full arterial compliance benefits may take up to 3 months to achieve, even though blood pressure reduction occurs more quickly 6