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High blood pressure - medicine-related

Hypertension - medication related; Drug-induced hypertension

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

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)

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 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

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, eds. National Kidney Foundation's Primer on Kidney Diseases. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 66.

  • Hypertension

    Animation

  •  

    Hypertension - Animation

    If your doctor told you that you have high blood pressure, you may have wondered, what's the big deal? Well high blood pressure IS a big deal, because it can lead to a heart attack, stroke, vision loss, and kidney disease, sometimes before you even realize you have it. When you have high blood pressure, you'll want to control it before it can lead to these dangerous complications. Let's talk about high blood pressure, otherwise known as hypertension. Blood pressure measures the force at which your blood rushes against the walls of your arteries as your heart pumps it through your body. The higher the force, meaning the higher your blood pressure, the harder your heart has to work. High blood pressure damages not only your heart but also your arteries. When your doctor or nurse measures your blood pressure, you'll see two numbers. The top number is called systolic blood pressure. That's the force of blood in your arteries whenever your heart beats. The bottom number measures diastolic blood pressure, or the force of blood in between heartbeats. You're more likely to have high blood pressure if you don't exercise regularly, you're obese, you eat too much salt, you have diabetes, you smoke, or you have a family history of high blood pressure. Most of the time, you won't know that you have high blood pressure. That's because high blood pressure usually doesn't cause symptoms. Unless you get your blood pressure checked, you may have no idea there's a problem until you develop heart disease or another complication. If your blood pressure is high, a few simple lifestyle changes can help bring it back down, and prevent its complications. Eat a heart-healthy diet that includes plenty of fresh fruits and vegetables, whole grains, and low-fat dairy, avoid fatty, salty, and sugary foods, exercise at least 30 minutes a day, limit salt to 1,500 milligrams or less a day, that's less than a teaspoon per day, and if you smoke, now is the perfect time to quit. Ask your doctor for tips on how to kick the habit. If these measures don't work, your doctor may prescribe one or more medicines to control your blood pressure. Because high blood pressure can sneak in without warning, stop it before it starts. Stay healthy, and your blood pressure checked at least once a year. If you already have high blood pressure, follow your doctor's advice to get it under control.

  • Drug induced hypertension - illustration

    Drug-induced hypertension is high blood pressure caused by a response to using, or stopping the use of, a chemical substance, drug, or medicine.

    Drug induced hypertension

    illustration

  • Untreated hypertension - illustration

    Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medicines, lifestyle changes, or a combination of both.

    Untreated hypertension

    illustration

  • Hypertension - illustration

    Hypertension is a disorder characterized by consistently high blood pressure. Blood pressure readings are given as two numbers. The top number is called systolic blood pressure, and it represents the pressure generated when the heart beats. The bottom number is called diastolic blood pressure, and it represents the pressure in the vessels when the heart is at rest. Persistent high blood pressure can lead to abnormal changes in the heart.

    Hypertension

    illustration

  • Hypertension

    Animation

  •  

    Hypertension - Animation

    If your doctor told you that you have high blood pressure, you may have wondered, what's the big deal? Well high blood pressure IS a big deal, because it can lead to a heart attack, stroke, vision loss, and kidney disease, sometimes before you even realize you have it. When you have high blood pressure, you'll want to control it before it can lead to these dangerous complications. Let's talk about high blood pressure, otherwise known as hypertension. Blood pressure measures the force at which your blood rushes against the walls of your arteries as your heart pumps it through your body. The higher the force, meaning the higher your blood pressure, the harder your heart has to work. High blood pressure damages not only your heart but also your arteries. When your doctor or nurse measures your blood pressure, you'll see two numbers. The top number is called systolic blood pressure. That's the force of blood in your arteries whenever your heart beats. The bottom number measures diastolic blood pressure, or the force of blood in between heartbeats. You're more likely to have high blood pressure if you don't exercise regularly, you're obese, you eat too much salt, you have diabetes, you smoke, or you have a family history of high blood pressure. Most of the time, you won't know that you have high blood pressure. That's because high blood pressure usually doesn't cause symptoms. Unless you get your blood pressure checked, you may have no idea there's a problem until you develop heart disease or another complication. If your blood pressure is high, a few simple lifestyle changes can help bring it back down, and prevent its complications. Eat a heart-healthy diet that includes plenty of fresh fruits and vegetables, whole grains, and low-fat dairy, avoid fatty, salty, and sugary foods, exercise at least 30 minutes a day, limit salt to 1,500 milligrams or less a day, that's less than a teaspoon per day, and if you smoke, now is the perfect time to quit. Ask your doctor for tips on how to kick the habit. If these measures don't work, your doctor may prescribe one or more medicines to control your blood pressure. Because high blood pressure can sneak in without warning, stop it before it starts. Stay healthy, and your blood pressure checked at least once a year. If you already have high blood pressure, follow your doctor's advice to get it under control.

  • Drug induced hypertension - illustration

    Drug-induced hypertension is high blood pressure caused by a response to using, or stopping the use of, a chemical substance, drug, or medicine.

    Drug induced hypertension

    illustration

  • Untreated hypertension - illustration

    Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medicines, lifestyle changes, or a combination of both.

    Untreated hypertension

    illustration

  • Hypertension - illustration

    Hypertension is a disorder characterized by consistently high blood pressure. Blood pressure readings are given as two numbers. The top number is called systolic blood pressure, and it represents the pressure generated when the heart beats. The bottom number is called diastolic blood pressure, and it represents the pressure in the vessels when the heart is at rest. Persistent high blood pressure can lead to abnormal changes in the heart.

    Hypertension

    illustration

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Review Date: 10/2/2020

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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