Types of Hypertension
Medications That Can Cause Hypertension
Many drugs, including some over-the-counter preparations, can elevate blood pressure (see Drugs That Can Raise Blood Pressure, below). Certain medications prescribed for autoimmune diseases — such as glucocorticoids (also called corticosteroids), cyclosporine, and tacrolimus — constrict blood vessels throughout the body, as do some cancer-treating agents. Hypertension may also be a side effect of nasal decongestants, anabolic steroids, or MAO inhibitors (a class of antidepressants), as well as nonsteroidal anti-inflammatory drugs known as NSAIDs (Advil, Aleve) and COX-2 inhibitors (Celebrex), two popular classes of pain relievers. In addition, NSAIDs and COX-2 inhibitors can cause kidney dysfunction, and in some cases, cardiovascular effects so discuss your personal health risks with your doctor when considering the regular use of these medications.
The decongestants found in most over-the-counter cold, flu, and allergy medicines and many weight-loss supplements can also elevate blood pressure and interfere with medications used to treat hypertension. The FDA banned one of the most common of these decongestants, phenylpropanolamine (PPA), because it was linked to an increased risk of stroke, especially in women. Fortunately, some cold, cough, and flu remedies are specially formulated for people with high blood pressure. However, it’s always a good idea to talk to your doctor before taking any over-the-counter medications.
Shortly after birth control pills came on the market in the ’60s, researchers discovered they raised blood pressure, sometimes to dangerously high levels. As a result, they were found to increase a woman’s risk of having a stroke, particularly among smokers. However, these early oral contraceptives contained considerably higher doses of estrogen and progesterone than current formulations do. Today, it’s much less common for oral contraceptives to cause hypertension, and when it does occur, it’s usually among women who smoke, are obese, or are over 35. In these cases, blood pressure usually returns to normal after the woman stops taking the pill.
The ingestion of lead and cadmium can also cause hypertension.
Drugs That Can Raise Blood Pressure
Prescription Drugs
anabolic steroids
bromocriptine
ergotamine
glucocorticoids or corticosteroids (such as prednisone)
COX-2 inhibitors (such as celecoxib)
cyclosporine
disulfiram
erythropoietin
estrogens
lithium
MAO inhibitors
tacrolimus
tricyclic antidepressants
Over-the-Counter Drugs
nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, indomethacin, naproxen
phenylephrine (found in nasal sprays)
phenylpropanolamine (an FDA-banned substance once found in appetite suppressants and in over-the-counter cold and allergy medicines)
pseudoephedrine (found in cold and allergy preparations)
From the Harvard Health Publications Special Health Report, Hypertension: Controlling the "Silent Killer." Copyright 2004 by the President and Fellows of Harvard College. Illustrations by Marie Duprey and Harriet Greenfield, M.A.. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.