Should I discontinue losartan 50 mg daily if my blood pressure falls below 110/80 mmHg?

Should You Stop Losartan 50 mg When Blood Pressure Falls Below 110/80 mmHg?

No, you should not automatically discontinue losartan 50 mg when your blood pressure falls below 110/80 mmHg—this reading is within the acceptable therapeutic range and does not indicate overtreatment unless you are experiencing symptoms of hypotension (dizziness, lightheadedness, fatigue, syncope). 1

Understanding Your Blood Pressure Reading

• A blood pressure of 110/80 mmHg is actually optimal and falls within the guideline-recommended target range of 120-129 mmHg systolic (or <140/90 mmHg minimum) for most adults with hypertension 1
• The European Society of Cardiology explicitly recommends targeting systolic blood pressure of 120-129 mmHg when well tolerated, making 110 mmHg systolic acceptable if you have no symptoms 1
• Blood pressure naturally fluctuates throughout the day by 10-20 mmHg, so a single reading of 110/80 mmHg does not necessarily represent your average blood pressure 2

When to Consider Medication Adjustment

Symptomatic hypotension is the key indicator for dose reduction or discontinuation:

• Stop or reduce losartan if you experience dizziness upon standing, lightheadedness, fatigue, blurred vision, or near-syncope—these symptoms indicate your blood pressure is too low for your body 1
• Check for orthostatic hypotension by measuring blood pressure after 5 minutes lying down, then at 1 and 3 minutes after standing; a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic with symptoms warrants dose reduction 1
• If your blood pressure consistently measures <100/60 mmHg with symptoms, this represents true hypotension requiring medication adjustment 1

Critical Monitoring Steps

• Confirm the reading with home blood pressure monitoring using a validated device, taking measurements at the same time daily for 5-7 days 1, 3
• Measure blood pressure in both sitting and standing positions to detect orthostatic changes, especially if you are elderly 1
• Average multiple readings before making any medication changes—a single low reading is insufficient to justify stopping therapy 1

Losartan Dosing Context

• The FDA-approved starting dose of losartan is 50 mg once daily, with a maximum dose of 100 mg daily for blood pressure control 4
• Losartan 50 mg provides sustained 24-hour blood pressure reduction with a smooth, gradual onset of action 5, 6
• The drug is well-tolerated with adverse effects comparable to placebo, and first-dose hypotension is uncommon 7, 5

Common Pitfalls to Avoid

• Do not stop antihypertensive medication based solely on a single blood pressure reading—this can lead to rebound hypertension and increased cardiovascular risk 1
• Do not discontinue losartan without consulting your physician, as abrupt withdrawal can cause blood pressure to spike, particularly if you have underlying cardiovascular disease 2
• Do not assume asymptomatic low-normal blood pressure requires treatment adjustment—the goal of hypertension therapy is to achieve and maintain optimal blood pressure control 1, 3

When to Contact Your Physician

• If you experience any symptoms of hypotension (dizziness, lightheadedness, fatigue, syncope) 1
• If your home blood pressure consistently measures <100/60 mmHg over 5-7 days 1
• If you have documented orthostatic hypotension with a drop of ≥20/10 mmHg upon standing with symptoms 1
• Before making any changes to your medication regimen 1, 3

Alternative Management Strategy

• If your blood pressure is consistently 100-110/60-70 mmHg without symptoms, your physician may consider reducing losartan from 50 mg to 25 mg daily rather than stopping it completely 4
• The FDA label recommends a starting dose of 25 mg for patients with possible intravascular depletion (e.g., on diuretic therapy), indicating this lower dose is safe and effective 4
• Maintain lifestyle modifications (sodium restriction <2 g/day, regular exercise, weight management) to help stabilize blood pressure at optimal levels 1, 3