Written by: Chinonso Ahanonu

Are Your Medications Secretly Raising Your Blood Pressure?

Feeling on edge lately? Maybe a little more headachy or just off? While you might be chalking it up to stress, could one of your medications be quietly nudging your blood pressure higher? It’s a sneaky side effect that doesn’t always shout its presence, but it’s definitely something to be aware of! Think of your blood pressure as the force of your blood pushing against the walls of your arteries. When it’s too high (hypertension), it can put extra strain on your heart and blood vessels over time, increasing the risk of serious health issues.¹ So, keeping an eye on it is super important. Now, you might be taking medications for all sorts of reasons – allergies, pain, mental health, even just a stuffy nose. But guess what? Some common over-the-counter (OTC) and prescription drugs can have the unexpected effect of raising your blood pressure.² It’s like they have a little secret agenda your body isn’t thrilled about!

The Usual Suspects: Medications That Can Be Sneaky

This isn’t to say these medications are bad – they serve important purposes! But knowing about this potential side effect empowers you to have informed conversations with your doctor. Here are some common culprits:

Over-the-Counter Pain Relievers (NSAIDs): Think ibuprofen (Advil, Motrin) and naproxen (Aleve).³ These are great for aches and pains, but they can sometimes cause your body to retain fluid and narrow blood vessels, leading to a blood pressure increase.¹This effect is more likely with frequent or long-term use, especially in people with existing hypertension, kidney disease, or heart conditions.
Decongestants: Those handy nasal sprays and pills containing pseudoephedrine or phenylephrine work by narrowing blood vessels in your nose.⁵ Unfortunately, they can also narrow other blood vessels, potentially raising your blood pressure.²
Certain Antidepressants: Some types of antidepressants, particularly SNRIs (serotonin-norepinephrine reuptake inhibitors) and older MAOIs (monoamine oxidase inhibitors), can affect neurotransmitters in a way that might lead to increased blood pressure in some individuals.³
Hormonal Birth Control: Especially pills containing estrogen, can sometimes cause a slight increase in blood pressure in some women.⁴ This is more common in older women, those who smoke, or those with other risk factors.⁴
Corticosteroids: These medications, like prednisone, are used for inflammation and various other conditions.⁹ They can sometimes cause fluid retention and electrolyte imbalances that can elevate blood pressure.⁹
Some Migraine Medications: Certain triptans, used to treat migraines, can narrow blood vessels, which might temporarily increase blood pressure in some people.⁶ Because of this, triptans are not recommended for people with uncontrolled hypertension or cardiovascular (heart) disease.
Herbal Supplements: Believe it or not, some supplements like licorice root, ephedra (now banned in many places but found in some older products or online), and St. John’s Wort can also interfere with blood pressure levels.⁸

What Can YOU Do? Be Your Own Detective!

This isn’t about panicking and throwing out all your medications! It’s about being informed and proactive:

Know Your Numbers: If you don’t already, start getting your blood pressure checked regularly. Your doctor can do this during appointments, or you can even get a home blood pressure monitor. Knowing your baseline is key.
Read Labels Carefully: Pay attention to the active ingredients in OTC medications and any warnings about blood pressure.
Tell Your Doctor EVERYTHING: Make sure your doctor knows all the medications you’re taking, including prescriptions, OTC drugs, vitamins, and herbal supplements. Don’t leave anything out.
Don’t Be Afraid to Ask: If you’re concerned about a medication’s potential impact on your blood pressure, ask your doctor or pharmacist directly. They can explain the potential side effects and monitor you if needed.
Never Stop Medications Suddenly: If you suspect a medication is raising your blood pressure, don’t stop taking it without talking to your doctor first. Suddenly stopping some medications can be dangerous.
Lifestyle Matters: Remember that healthy habits like a balanced diet, regular exercise, maintaining a healthy weight, and managing stress can all play a big role in keeping your blood pressure in a healthy range.⁹

Knowledge is Power

The good news is that often, if a medication is raising your blood pressure, your doctor can adjust the dose, switch you to a different medication, or help you manage it in other ways. The key is to be aware of the possibility and to have open communication with your healthcare team. By being informed and proactive, you can ensure all your medications are working for your health, not secretly against it!

References

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Ferrari, M. D., Goadsby, P. J., Roon, K. I., & Lipton, R. B. (2002). Triptans (serotonin, 5-HT1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials. Cephalalgia : an international journal of headache, 22(8), 633–658. https://doi.org/10.1046/j.1468-2982.2002.00404.x
Stewart, P.M., Valentino, R., Wallace, A.M., Burt, D., Shackleton, C., & Edwards, C.W. (1987). Mineralocorticoid activity of liquorice: 11-beta-hydroxysteroid dehydrogenase deficiency comes of age.The Lancet, 330, 821-824.
Gaster, B., & Holroyd, J. (2000). St John’s wort for depression: a systematic review. Archives of internal medicine, 160(2), 152–156. https://doi.org/10.1001/archinte.160.2.152
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr, Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr, Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr, Williamson, J. D., … Wright, J. T., Jr (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension (Dallas, Tex. : 1979), 71(6), 1269–1324. https://doi.org/10.1161/HYP.0000000000000066