Blood pressure (BP) changes caused by drugs or other agents have been linked with triggering hypertension (HTN), worsening control in patients, or reducing the effect of antihypertensive therapy. This article specifies those commonly prescribed drugs by family physicians.

BP-impairing drugs and substances

Multiple substances, including prescription drugs, over-the-counter pharmaceuticals, herbal supplements, and dietary ingredients, might impact blood pressure (BP). Changes in blood pressure caused by medications and other agents have been linked to the development of hypertension, deterioration of hypertension control in a patient who already has hypertension, and attenuation of antihypertensive therapy's blood pressure-lowering benefits.

Alterations in blood pressure may also happen from drug–drug and drug–food interactions. In the clinical evaluation of hypertension, a thorough history of substances that may compromise blood pressure (BP) regulation should be obtained, with special emphasis devoted to prescription medicines, over-the-counter pharmaceuticals, illegal drugs, and herbal supplements. When possible, blood pressure-raising medicines should be lowered or terminated, and alternative agents should be used.

1. In adults, alcoholic drinks, amphetamines, and some antidepressants may raise blood pressure. Limit alcohol consumption and quit or investigate alternatives for the two groups of medications.
2. Reduce the risk of blood pressure increase in individuals with uncontrolled HTN by recommending caffeine restriction and coffee abstinence. Use decongestants for the shortest duration feasible, or replace them with an alternate treatment.
3. Women with uncontrolled hypertension should not use oral contraceptives. Use low-dose or progestin-only formulations for the remainder.
4. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) and systemic corticosteroids (systemic corticosteroids) should be avoided or reduced wherever feasible; investigate alternatives for both when suitable.
5. Consider switching from cyclosporine to tacrolimus, which may have a lesser impact on blood pressure. To prevent BP rises, patients should refrain from using herbal supplements and any recreational drugs.
6. When treatment for cancer requires the use of angiogenesis inhibitors or tyrosine kinase inhibitors, initiate antihypertensive therapy or intensify therapy on board.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Monish Raut is a practising super specialist from New Delhi.