Should You Change Your Own Blood Pressure Medicine Dosing?

A reader wants to know

I am on blood pressure medicine for HBP. In the last few days my blood pressure has been pretty low. I probably could fix this by reducing or eliminating the medication. I don't want to bother my doctor, but I'm reluctant to substitute my judgment for his on this matter. The problem is, I don't know what all he has in mind in prescribing the medication. If I call his nurse for advice she will want me to come in.

He's already reduced the medication once before. At that time he did not give me instructions to reduce it on my own, so I'm thinking he might expect me to call him. The last time I had this problem, the nurse suggested he was going to change medications, but he didn't, he reduced the dose instead.

Is this something I should just be managing myself, or does my doctor need to make the decision every time? I don't mind going in, but I don't want to bother him, either, with trivial problems. 

I think I may have answered my own question. If the nurse can't anticipate what he's going to do, how can I be expected to know what to do?

I would still appreciate any insight you have into how doctors think, especially on blood pressure maintenance.

Low blood pressure is not a trivial problem.  If you have other medical problems it can cause angina.  It can cause stroke.  Perhaps kidney failure.  Syncope.  Trauma.  Electrolyte disturbances.  Arrhythmias.  Kidney stones.  Blood pressure management has many fine nuances that should be considered when adjusting or changing medications.  These include age, medical conditions, lifestyle, genetics, race, weight, side effects, interactions.

I actually believe an individual should have the right to purchase all their own medications and manage them as they see fit and seek medical opinions on their own terms.  We are free to consume toxic waste on a daily basis and smoke till our hearts desire, but we can't order our own thyroid medication (unless you have the luxury of being a physician).

So, if it was me, I would seek the opinion of a physician before changing a blood pressure medication due to the complexities in the decision making that never make it past the conscious thought process of the physician.    Thought processes that are complicated on many different levels.  Thought processes that you will never hear your physician discuss.  It looks easy on the surface but I can assure you,  much goes into the thought processes of medical decision making, decision making that will never be documented anywhere.