High blood pressure or hypertension, is a widespread issue affecting about 1.3 billion people globally. It is the leading preventable risk factor for cardiovascular disease, claiming around 10 million lives each year, according to the World Heart Federation. While managing hypertension is crucial, many people do not realise that certain medications can contribute to rising blood pressure without them even knowing. From common painkillers and antidepressants to decongestants, these drugs can pose a significant risk, especially for those already dealing with hypertension. It is essential to be aware of these medications and their potential effects, so learn whether it is one of the causes of high blood pressure.

What is high blood pressure?

Hypertension occurs when the force of blood against the walls of your arteries is too high. This can strain your heart and blood vessels, leading to health problems like heart disease, stroke, and kidney damage. Blood pressure is measured in millimetres of mercury (mm Hg) and is recorded as two numbers: systolic (pressure during a heartbeat) and diastolic (pressure between heartbeats). A normal reading is usually around 120/80 mm Hg. Hypertension is typically defined as having a reading of 130/80 mm Hg or higher.

9 medications that can cause high blood pressure

While there are several causes of high blood pressure, certain medications can also cause a spike, including:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs)

“NSAIDs include both prescription and over-the-counter medications commonly used for quick relief from persistent pain and to reduce inflammation, particularly in conditions like arthritis,” explains cardiologist Dr Sameer V Pagad. However, these medications can cause the body to retain excess fluid, negatively impacting kidney function. When the kidneys are not working efficiently, it can lead to significant fluctuations in blood pressure, ultimately resulting in hypertension. Additionally, taking NSAIDs, especially in higher doses or taking them for one week, one month, or more than one month, can increase the risk of heart attack or stroke, according to a study published in the British Medical Journal.

NSAIDs can cause high blood pressure. Image courtesy: Freepik

NSAIDs are also present in various over-the-counter products, such as cold medications. It is advisable to consult your doctor to determine whether NSAIDs are suitable for you. Your physician may suggest alternatives, like acetaminophen instead of ibuprofen.

2. Corticosteroids or steroids

Corticosteroids, commonly referred to as steroids, are medications designed to mimic hormones produced by the adrenal glands. They help reduce inflammation and suppress the immune system. However, regular use of corticosteroids can significantly increase sodium reabsorption in the kidneys, leading to fluid retention. This fluid buildup can place extra strain on blood vessels, causing them to constrict and resulting in elevated blood pressure levels. A study published by the Canadian Respiratory Journal also found a link between the use of oral corticosteroids and the occurrence of high blood pressure and acute myocardial infarction, also known as heart attack.

Additionally, corticosteroids can disrupt the metabolism of your body and contribute to weight gain, which may further exacerbate hypertension. Higher doses of these medications are associated with an even greater risk of increased blood pressure.

3. Cold medicines or decongestants

Cold medicines, particularly decongestants, are commonly used for quick relief from nasal congestion. They work by narrowing the blood vessels in the nasal passages, which reduces swelling. However, many cold and cough medications also contain NSAIDs to alleviate pain, and as previously mentioned, NSAIDs can raise blood pressure. Overusing these medications can be detrimental to your blood pressure levels. Additionally, certain decongestants may stimulate the heart and further increase blood pressure and heart attack, according to the Annals of Emergency Medicine. While these drugs help reduce nasal swelling, they can also constrict blood vessels throughout the body, contributing to hypertension.

If you have blood pressure concerns, it is best to avoid cough and cold medications containing NSAIDs or decongestants, especially pseudoephedrine (Sudafed), which is known to raise blood pressure. Consult your doctor for alternative options to relieve congestion, such as antihistamines or nasal sprays.

4. Antidepressants

Antidepressants are often prescribed for people dealing with mental health issues such as depression, anxiety, chronic stress, panic disorder, and overthinking. When taken as directed by a healthcare provider, these medications can help restore balance to the chemicals in the brain that influence mood and emotional well-being. "While high blood pressure is not a common side effect of antidepressants, individuals with existing hypertension may face an increased risk. This risk can escalate further with higher doses of the medication," says Dr Pagad. Examples of antidepressants that may contribute to hypertension include:

• Monoamine oxidase inhibitors (MAOIs)
• Tricyclic antidepressants (TCAs)
• Selective serotonin reuptake inhibitors (SSRIs)

It is important to monitor your blood pressure regularly if you are on antidepressants. Also, if you experience elevated blood pressure or find it poorly controlled, consult your healthcare provider about alternative medications.

5. Immunosuppressants

Immunosuppressants are medications that weaken the immune system. They are often prescribed to prevent organ rejection after a transplant or to manage flare-ups of autoimmune conditions. However, some immunosuppressants can lead to increased blood pressure, reveals a study published in Frontiers in Cardiovascular Medicine. Notable examples include cyclosporine (Sandimmune, Gengraf, and Neoral) and sirolimus (Rapamune). These medications may raise blood pressure by constricting blood vessels and causing the kidneys to retain salt. If you are on immunosuppressants, it is advisable to have your blood pressure monitored regularly.

These medications increase the risk of hypertension! Image courtesy: Adobe Stock

6. Migraine medications

Migraines are linked to a higher prevalence of cardiovascular disease (CVD) risk factors, including hypertension, diabetes, and hyperlipidemia, according to a study published by the American Academy of Neurology. Certain migraine medications, such as triptans, relieve pain by constricting blood vessels in the head. While effective for managing migraine symptoms, these drugs narrow blood vessels throughout the body, potentially leading to high blood pressure, which may reach dangerous levels.

The same study highlights that medications that constrict coronary arteries, including triptans and compounds containing ergotamine, could increase the risk of CVD in patients being treated for migraines. If you have hypertension or any heart-related conditions, it is essential to consult your doctor before using medications for migraines or severe headaches.

7. Birth control with estrogen

Some individuals using hormonal birth control, particularly pills containing estrogen, may experience an increase in blood pressure. “The vaginal ring has also been associated with high blood pressure in some users. While modern birth control methods typically contain lower levels of estrogen, this side effect can still occur. Estrogen may contribute to elevated levels of blood pressure by increasing levels of a protein called angiotensinogen, which converts to angiotensin II, a substance known to raise blood pressure, mentions Dr Pagad.

In most cases, hormonal birth control does not significantly impact blood pressure. However, if you have existing hypertension, your healthcare provider may suggest using a progestin-only pill or alternative methods, such as an arm implant or an intrauterine device (IUD).

8. Stimulants

Stimulants, such as methylphenidate (Concerta, Ritalin, and others), can lead to an increased heart rate or irregular heartbeat, which may elevate blood pressure, as per StatPearls. These medications work by enhancing the activity of specific chemicals in the brain, improving focus and attention. However, they can also increase the risk of blood pressure-related issues by activating the sympathetic nervous system, leading to palpitations and constricted blood vessels, both of which contribute to higher blood pressure. If you are taking a stimulant, keep your blood pressure in check regularly.

9. Weight loss drugs

Certain weight loss or obesity medications, such as sibutramine, can exacerbate heart disease. These medications can increase your risk of cardiovascular diseases such as heart attack, angina, stroke, heart arrhythmias, and congestive heart failure, according to a study published by the American Diabetes Association. Appetite suppressants, in particular, can increase the activity level of your body, leading to elevated blood pressure and added stress on the heart. Before starting any weight loss drug—whether prescription or over-the-counter—it is essential to consult your doctor. While these medications can aid in weight loss, they may also pose risks that outweigh their benefits.

If you are taking any of these medications, especially if you have a history of high blood pressure, it is important to keep a check on your blood pressure regularly and consult with your healthcare provider about the best options for your health.

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