Staying Fit
Headed to the pharmacy for something to relieve your aching, sneezing, stuffed-up symptoms? If you’re among the 70 percent of adults 65 and older with high blood pressure, also called hypertension, you may want to think twice before grabbing one of many over-the-counter options.
That’s because decongestants, a common ingredient in cold and flu medications, can raise your blood pressure or even interfere with the effectiveness of blood pressure pills you may be taking, according to the American Heart Association.
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“It’s kind of a general thing that [decongestants] are not a good idea for people with high blood pressure,” says Sandra J. Taler, M.D., a professor of medicine and a physician in the Division of Nephrology and Hypertension at the Mayo Clinic. “And probably a lot of people don’t know that.”
Similarly, some pain relievers that people take to treat a cold or the flu come with risks for people with high blood pressure.
How do decongestants raise blood pressure?
Decongestants stimulate the muscles in the artery walls, causing them to constrict or narrow, explains Matthew F. Muldoon, M.D., founding director of the Hypertension Center at the UPMC Heart and Vascular Institute and professor of medicine at the University of Pittsburgh School of Medicine.
This so-called vasoconstriction relieves swelling in the nose and keeps fluid from getting into the sinuses, which is helpful if you are congested. But it also “causes the pressure inside the arteries to increase a little bit,” Muldoon says.
The effect decongestants have on blood pressure is especially a concern for people who have heart disease and whose high blood pressure is not well controlled, Muldoon says.
Cold and flu medications to avoid if you have high blood pressure
It’s not always obvious what pills and liquids on the pharmacy shelf contain decongestants. There are a handful of decongestant-only products — Sudafed Sinus Congestion is one example — but most often, decongestants are included in combination products that target a range of symptoms, congestion being just one of them.
How can you tell if a decongestant is in your cold and flu medicine? Taler says to look on the ingredient list for:
- Pseudoephedrine
- Phenylephrine (Note: A Food and Drug Administration advisory panel recently concluded that the decongestant phenylephrine, when taken orally, is not effective at relieving congestion. However, it’s not harmful, so it remains on the market until the agency decides to remove it.)
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