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High blood pressure - medicine-related

Definition

Drug-induced hypertension is high blood pressure caused by a chemical substance or medicine.

Alternative Names

Hypertension - medication related; Drug-induced hypertension

Causes

Blood pressure is determined by the:

  • Amount of blood the heart pumps
  • Condition of the heart valves
  • Pulse rate
  • Pumping power of the heart
  • Size and condition of the arteries

There are several types of high blood pressure:

  • Essential hypertension has no cause that can be found (many different genetic traits contribute to essential hypertension, each one having a relatively small effect).
  • Secondary hypertension occurs because of another disorder.
  • Drug-induced hypertension is a form of secondary hypertension caused by a response to a chemical substance or medicine.
  • Pregnancy-induced hypertension.

Chemical substances and medicines that can cause high blood pressure include:

  • Acetaminophen
  • Alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine
  • Angiogenesis inhibitors (including tyrosine kinase inhibitors and monoclonal antibodies)
  • Antidepressants (including venlafaxine, bupropion, and desipramine)
  • Black licorice
  • Caffeine (including the caffeine in coffee and energy drinks)
  • Corticosteroids and mineralocorticoids
  • Ephedra and many other herbal products
  • Erythropoietin
  • Estrogens (including birth control pills)
  • Immunosuppressants (such as cyclosporine)
  • Many over-the-counter medicines such as cough/cold and asthma medicines, particularly when the cough/cold medicine is taken with certain antidepressants, such as tranylcypromine or tricyclics
  • Migraine medicines
  • Nasal decongestants
  • Nicotine
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Phentermine (a weight loss medicine)
  • Testosterone and other anabolic steroids and performance-enhancing drugs
  • Thyroid hormone (when taken in excess)
  • Yohimbine (and Yohimbe extract)
Drug induced hypertension
Drug-induced hypertension is high blood pressure caused by a response to using, or stopping the use of, a chemical substance, drug, or medicine.

Rebound hypertension occurs when blood pressure rises after you stop taking or lower the dose of a drug (typically a medicine to lower high blood pressure).

  • This is common for medicines that block the sympathetic nervous system like beta blockers and clonidine.
  • Talk to your health care provider to see if your medicine needs to be gradually tapered before stopping.

Many other factors can also affect blood pressure, including:

  • Age
  • Condition of the kidneys, nervous system, or blood vessels
  • Genetics
  • Foods eaten, weight, and other body-related variables, including the amount of added sodium in processed foods
  • Levels of various hormones in the body
  • Volume of water in the body

Gallery

Drug induced hypertension
Drug-induced hypertension is high blood pressure caused by a response to using, or stopping the use of, a chemical substance, drug, or medicine.
Tracking your blood pressure at home
Following your blood pressure at home has gotten a lot easier in the last few years. I'm Dr. Alan Greene. I'd like to share with you a little bit about that. Not too long ago when you wanted to follow your blood pressure at home, you had to have the old fashion sphygmomometer, and the device was a complex as that word sounds. You had to pump something up, and put a stethoscope in your ears, and fumble all these different tubes and even so wouldn't get a very accurate reading. Now, there are simple, high quality, digital blood pressure cuffs. They're easy to use at home. They're built so they snap on the arm very easily, just press a single button, and the chip inside does the work for you. It blows it up, it gives you the reading, and some of the newer models even connect it to your PC and track the readings for you. Now, how accurate are they? They're really pretty good. I wouldn't trust a single reading that much if you get one that's high or low. I wouldn't be either reassured or panicked. But, I would trust the pattern of readings. So, if you have one that tracks it for you, that's great, if not, just write them down what date and time you took it and see what the pattern is over time. If there's anything of concern, be sure to report it to your physician.
Drug induced hypertension
Drug-induced hypertension is high blood pressure caused by a response to using, or stopping the use of, a chemical substance, drug, or medicine.

References

Bobrie G, Amar L, Faucon A-L, Madjalian A-M, Azizi M. Resistant hypertension. In: Bakris GL, Sorrentino MJ, eds. Hypertension: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 43.

Charles L, Triscott J, Dobbs B. Secondary hypertension: discovering the underlying cause. Am Fam Physician. 2017;96(7):453-461. PMID: 29094913 pubmed.ncbi.nlm.nih.gov/29094913/.

Grossman A, Messerli FH, Grossman E. Drug induced hypertension--an unappreciated cause of secondary hypertension. Eur J Pharmacol. 2015;763(Pt A):15-22. PMID: 26096556 pubmed.ncbi.nlm.nih.gov/26096556/.

Jurca SJ, Elliott WJ. Common substances that may contribute to resistant hypertension, and recommendations for limiting their clinical effects. Curr Hypertens Rep. 2016;18(10):73. PMID: 27671491 pubmed.ncbi.nlm.nih.gov/27671491/.

Peixoto AJ. Secondary hypertension. In: Gilbert SJ, Weiner DE, Bomback AS, eds. National Kidney Foundation Primer on Kidney Diseases. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 65.

Last reviewed November 3, 2022 by Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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