Medications and Supplements to Avoid if You Have High Blood Pressure

Decongestants

If you have wondered why many nasal decongestants are located in the restricted-access section of pharmacies, here’s one reason: Many of them include a recommendation to ask a doctor before use if you have a history of high blood pressure or heart disease, among other conditions.

The primary ingredients in many OTC decongestants constrict blood vessels in the nose and sinuses. Unfortunately, they also tighten blood vessels throughout the body, which may cause a marked rise in blood pressure in people with severe or uncontrolled hypertension.

Amphetamines, stimulants

Amphetamine, a psychomotor stimulant prescribed for attention deficit hyperactivity disorder, sleep disorders and sometimes obesity is a drug that can rapidly and acutely increase blood pressure by stimulating the nervous system and constricting blood vessels. Using stimulants such as amphetamines or cocaine can lead to dangerous spikes in blood pressure; accelerated hypertension is a well-known complication of recreational stimulant use.

Corticosteroids

Oral steroids, a form of corticosteroids, are used in the management and treatment of numerous medical disorders. They help reduce inflammation and suppress the immune system by reducing the chemicals that cause inflammation and reducing immune system activity by affecting the way that blood cells work. Steroids are prescribed to treat rheumatoid arthritis, gout, lupus, asthma, allergic rhinitis, hives, inflammatory disorders, allergic and autoimmune diseases, inflammatory bowel disease, neurological disorders, prevention of graft and/or organ rejection, and skin disorders.

Unfortunately, steroids can cause or exacerbate hypertension, especially when used in high doses for more than two weeks. Corticosteroids like prednisone can cause the body to retain sodium and water and lose potassium, which can lead to fluid retention, weight gain and/or bloating, elevating blood pressure. People with risk factors for high or borderline high blood pressure may be more likely to develop the condition while taking prednisone.

People with uncontrolled hypertension should not take corticosteroids if at all possible, and patients currently on corticosteroids should talk with their providers about alternatives. Individuals taking high-dose corticosteroids for an extended period should monitor their blood pressure at least once a month after initiating this therapy.

Yohimbine, which can be prescribed alongside a primary treatment for sexual function, should not be taken by men who have been diagnosed with or are at risk for hypertension.

Which supplements to avoid if you have high blood pressure

Herbal supplements are natural. But are they safe? Three in particular should be avoided.

St. John’s Wort

St. John’s wort is associated with increased blood pressure and rapid heartbeat. It can cause serious and potentially dangerous interactions with multiple drugs and impact their effectiveness. St. John’s wort should not be taken with antidepressants such as selective serotonin reuptake inhibitors (SSRIs). Mixing the two can trigger serotonin syndrome, a potentially life-threatening condition that may cause high blood pressure and a rapid heartbeat, among other symptom.

Licorice root

Consuming large amounts of licorice root over a period of days to weeks can cause severe side effects, including heart attacks. The National Center for Complementary and Integrative Health advises that consuming excessive amounts of licorice root or for long periods of time may pose particular risks for people with hypertension.

Ginseng

The relationship between blood pressure and ginseng is a little murky. The herbal supplement used in traditional Chinese medicine for centuries may interact with certain medications, such as calcium channel blockers and other high blood pressure medications, as well as statin medications and some antidepressants. Studies on the effect of Asian ginseng on the blood thinner warfarin (Coumadin) are inconclusive. If you’re taking medication, the American Heart Association recommends talking with your health care provider before using Asian ginseng.

How to avoid taking medications that raise blood pressure

• Search PIMsPlus (www.pimsplus.org), a database of prescription and OTC medications that older adults should use with caution because the potential risk of adverse effects may outweigh the benefit. The database was developed and is regularly updated by eldercare pharmacy specialists.
• Provide complete medication information, including OTC meds and supplements, to each of your physicians. Patients who see multiple physicians should not assume each doctor knows what the others are doing. Communication among medical providers is a good way to determine if alternate treatments are necessary. If direct communication isn’t possible, try to bring medical records to doctor visits or request that electronic medical records be shared between providers. Most medical centers and clinics have electronic medical records; however, medication lists depend on clinic staff or physicians to enter in your medications—generic or brand name, dose, frequency of dosing, date started and reason for your taking it.
• You should prepare a written list of all medications, vitamins, supplements you are using, and the information and bring it with you to all medical appointments to allow the clinic staff and providers to review this in comparison to the list in your electronic medical record
• Use a single pharmacy whenever possible, and get to know your pharmacist. If you use multiple pharmacies, make sure that each one has a record of all your drugs, even those given to you as samples. That way, pharmacists will automatically be alerted if the prescription you’re looking to fill may be inappropriate for your drug regimen.

“If you take drugs for multiple health issues, such as hypertension, arthritis and diabetes, consultation with an ‘age-friendly’ pharmacist may be beneficial,” advises Chad Worz, a pharmacist and CEO of the American Society of Consultant Pharmacists (ASCP). “They will evaluate all the medications that a person is taking to try to ensure appropriate, effective and safe use.”

As advocates for older adults, these pharmacists follow what’s known as the 4Ms of the age-friendly movement: What Matters, Medications, Mentation and Mobility. “They specialize in identifying, resolving and preventing problems related to medications and ensure they fit with what is important to the individual and their lifestyle,” says Worz. “If changes are needed — providing an alternative drug, prescribing a lower dosage or discontinuing a drug altogether because its purpose is being met by another medication — older adult-care pharmacists will also notify a patient’s primary care physician of their findings and recommendations. They collaborate with PCPs to identify the best medication mix to achieve results and improve quality of life.”