Doctors and patients need to be aware of risks, TAU researcher cautions
Diseases such as kidney failure and endocrine tumors are among the suspects causing high blood pressure — but could the common pain relievers in your medicine cabinet be the culprit?
According to Prof. Ehud Grossman of Tel Aviv University's Sackler Faculty of Medicine and the Sheba Medical Center, many common over-the-counter and prescription medications are underlying causes of hypertension, which is a major risk factor for stroke, heart attack, and aneurisms. The chemical components of the drugs can raise blood pressure or interfere with anti-hypertensive medications, he explains. And while many medications can cause this drug-induced hypertension, both patients and doctors remain dangerously uninformed.
Weighing the treatment options
"In diagnosing the causes of hypertension, over-the-counter drugs like ibuprofen are often overlooked," says Prof. Grossman. Patients often assume that because a medication can be obtained without a prescription, it's relatively harmless. But that's not always the case.
Many of the medications that are linked with a rise in blood pressure are quite widely used, says Prof. Grossman, whose research provides an overview of which medications are related to high blood pressure. Examples include contraceptive pills, various anti-depressants, anti-inflammatory pills to control pain. and bacterial antibiotics.
Though high blood pressure is a known side effect of many of these medications, doctors do not always account for them in their treatment plans, and they don't inform patients of the potential risks associated with these medications. It's ultimately the doctor's responsibility to weigh treatment options and present the best course for their patient should issues of hypertension arise, Prof. Grossman says.
Doctors may be advised to decrease the dosage of the drug, or add an anti-hypertensive drug to the treatment regime, he says. In any case, awareness on the part of both doctors and patients needs to be raised. "Many physicians don't account for this, and some don't even know about it. It's their responsibility to be informed and make sure that their patients are aware that this is a possibility."
Cost and benefit
Though much of the time a course of treatment can be altered to account for the dangers of hypertension, that isn't always the case. For example, new anti-vascular endothelial growth factor drugs, which may increase blood pressure, block the formation of new blood vessels and arteries to solid tumors. Because the drugs are so effective in treating these malignancies, the benefit outweighs the cost, he believes.
But that doesn't mean that patients shouldn't be watched closely for signs of hypertension. "Once a patient has won a longer life with the use of these drugs, you don't want to expose them to problems associated with blood pressure, such as stroke," says Prof. Grossman. There are simple ways to counteract drug-induced hypertension, such as the thoughtful addition of anti-hypertensive medications to a treatment plan, he says.
The above story is reprinted from the March 20, 2012 news release by American Friends of Tel Aviv University.
Prof. Grossman’s research was published in the American Journal of Medicine:
Grossman E, Messerli FH. Drug-induced hypertension: an unappreciated cause of secondary hypertension. Am J Med. 2012 Jan;125(1):14-22.