Hypertension: Medications to Avoid with High Blood Pressure

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If you have hypertension there are common, over-the-counter (OTC) medicines that you should scrutinize before taking or completely avoid.

Hypertension, or high blood pressure, is a serious condition and one that far too many people don’t know they have. Yet to self-administer other non-prescriptive, “harmless” medicines that may increase blood pressure or undo the effects of treatment is to only exacerbate the problem.

I discovered that I was hypertensive while in college. I was in my late 20s but physically strong and fairly active. The discovery hit me like a ton of bricks and I had a hard time coping. The condition is in my family; but mine was a “Why me?” scenario when I was so young and fit.

I’ve managed to keep it controlled and to learn more about it and how to care for myself, including knowing what other medicines are permissible. Honestly, deadly medicine interactions, which we’ve all heard about, frighten me, and they should frighten you, too.

But scaring you is not the purpose of this discussion; making you informed and telling you—if you have hypertension—to play it safe is the purpose. Moreover, I will explain to you, in step-by-step fashion, the cause of hypertension, how treatment works, and how common remedies hinder treatment and contribute to the problem.

Categories of Blood Pressure

Normal: Less than 120/80

Pre-Hypertension: 120-139/80-89

Stage 1 HBP: 140-159/90-99

Stage 2 HBP: 160+/100+

Explaining High Blood Pressure

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What Causes High Blood Pressure?

Hypertension is a mysterious condition. Exact cause for most cases—between 90 and 95 percent of them—is normally undetermined. This is known as essential hypertension and is differentiated from secondary hypertension that can be directly linked to issues such as kidney disease, tumors, and even pregnancy.

High blood pressure is a study of deep biological and medical research that cannot be explained here. The best way to understand it, however, is to address its complexity.

Think of it this way: In the body and as it relates to blood pressure there are a few command centers—the heart, the kidneys, and parts of the nervous, circulatory, and endocrine (gland) systems. Several substances in these locations work to regulate the command centers. But abnormalities sometimes occur with these regulatory agents, and it is these abnormalities that are believed to bring on hypertension.

The way this destabilized state of the body affects the command centers is important to learn for later. The heart now undergoes increased cardiac output, meaning that the heart pumps a larger volume of blood into the blood vessels, thus raising blood pressure. The kidneys can deliver a double-blow. These organs control the body’s retention of fluid and sodium and contribute significantly to blood volume—a problem if fluid is not sufficiently excreted from the body. The kidneys also produce renin, an enzyme that controls vessel dilation; and renin, in conjunction with a hormone produced in the liver (angiotensin), causes blood pressure to increase due to the constriction of blood vessels.

The end results of this havoc, if left uncontrolled, are a plethora of cardiovascular diseases, stroke, and kidney disease.

The Silent Killer

Hypertension is known as the "silent killer" because it doesn't create symptoms. Are you certain that you don't have high blood pressure?

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Did You Know...

...that 68 million Americans or 1 in 3 or 25 percent of adults are hypertensive?

OTC Drugs for the Hypertensive

Four Classes of HBP Drugs

Diuretics - eliminate water and sodium from the body

Vasodilators - widen blood vessels

Cardioinhibitory - slow the heart and lessen the force of contractions

Sympatholytics - last resort drugs that work on nerve impulses

How Blood Pressure Medicines Work

Blood pressure medications bring control to this chaos. There are four classes: diuretics, vasodilators, cardioinhibitory, and central sympatholytic. The first three are the most commonly used with sympatholytic drugs required when patients do not respond to others.

Diuretics counter hypertension by causing the body to eliminate sodium and water, offsetting irregularities in the kidneys. You may have heard some people refer to their “water pills” since it may induce frequent and urgent urination. Thiazide diuretics are one of the most common types used in this category; and many people are familiar with one form of it, hydrochlorothiazide.

Vasodilators cause vessels to widen, thus countering effects of increased cardiac output and blood volume. There are several types of vasodilators and many of them work to regulate the effects of the enzymes and hormones already mentioned, for instance, the very common ACE inhibitors (angiotensin converting enzyme) (e.g., Vasotec, enalapril) and renin inhibitors (e.g., Tekturna).

Cardioinhibitory drugs work by decreasing the heart rate and the force exerted with each contraction. This retards increased cardiac output and decreases pressure on vessel walls. There are two types of drugs here: beta blockers and calcium-channel blockers.

Beta blockers (e.g., atenolol and metoprolol) slow the heart; but because of more potential side effects, they are used only with last resort. Calcium-channel blockers (e.g., Norvasc, amlodipine) reduce calcium, which relaxes blood vessels, thus leading to vasodilation.

If you have hypertension and use only one drug to control your condition, you are very lucky. But many people have to use two or three drugs in combination to manage the problem. I use three—an ACE inhibitor, beta blocker, and calcium-channel blocker.

READ LABELS!
READ LABELS! | Source

QUIZ: What Do You Know About High Blood Pressure?

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Common Medicines to Avoid with Hypertension

Now at this point our hypertension is under control. We know how it’s caused and how to treat it. Yet, invariably, life happens: we get a cold or injure ourselves, start a diet or perhaps a family—but this is no time to forget our health condition. Our choices here are important because they have the potential to destabilize everything we’ve corrected.

Some medicines must be avoided or discussed with a physician before taking.

One class of these is decongestants, which act as vasoconstrictors. Decongestants cause the heart to beat faster and blood vessels to tighten and so increase blood pressure. Read labels! If the product contains pseudoephedrine (e.g., Sudafed, TherFlu, Actifed, or any –D product), ephedrine, phenylephrine, naphazoline, synephrine, or oxymetazoline, avoid it. This goes for pills and topical nasal decongestants, too, like Afrin and Vicks Vapor Inhaler.

Another very important class of medications to avoid is NSAIDs, or non-steroidal anti-inflammatory drugs. These are pain relievers that also work as vasoconstrictors and cause the body to retain sodium. High doses of NSAID medicines can cause kidney disease, again boosting hypertension.

Popular NSAIDs are aspirin (Bayer, Ecotrin, Excedrin, Bufferin), ibuprofen (Advil, Motrin, Nupril), and naproxen (Aleve)—and others. I will also include here that migraine medications should be carefully selected as they have the tendency to constrict blood vessels in the head.

Weight loss medications often contain stimulants, like caffeine and ephedrine, and work as vasoconstrictors. Caffeine is often found in several OTC medications, including aspirin formulas. The advice here goes for weight loss and body enhancement product on most store shelves, purchased by regular shoppers; but a special warning goes to those who have high interest in bodybuilding, high-performance sport, training, and competitive fitness and use large quantities of specialized supplement. Be very careful of ingredient content. There is a real danger of incredibly high blood pressure and stroke. Talk with a doctor first about what is safe to use.

Oral contraceptives must be warned against because many of them contain estrogen, once again producing vasoconstriction—and so goes the story: Be wary of some hemorrhoid products (vasoconstriction) and allergy eye drops (Visine-A, Opcon-A, Naphcon-A) that contain decongestants (vasoconstriction), even some asthma products1.

I’ve only dealt with OTC medications; but know that many prescription drugs contain ingredients that are adverse to high blood pressure. This means that patients must talk to their doctors and not be afraid to ask questions and to keep asking them until they get answers. But most importantly, read labels—and research: not avoiding the medicines that raise blood pressure is to merely keep oneself sick.

Endnote

1 See TDAPharm comment in the Comments Section for excellent supplemental advice on this. Topically applied items, like nasal sprays, eye drops, and creams listed in the article deliver medication to a local area. This means a decongestant generally doesn't enter the circulatory system, affecting the entire body.

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Comments 17 comments

LisaNurse 2 years ago

Hello,

I know this post is old but I had to comment just to clarify a few things. You said that hypertension is undetermined for most people? Generally in the hospital you can figure out why a patient has hypertension. High cholesterol, high lipids, high sodium, poor diet plus lack of exercise, genetics, or a number of other problems. That is essential HTN. High blood pressure causes a number of serious, life threatening problems including organ failure, stroke, and death. Thus, you do not want to try to fix it own your own with natural remedies and not take the medication that has been prescribed to you. You can lower your blood pressure with diet and exercise, and some people can even go off of it. The thing you don't want to do is let your blood pressure remain high while you try to treat it own your own. That's how people die from it.

Your body is being damaged by the increase in pressure. It cannot correct that own it's own. If will try to compensate and do more damage in the process (damaging your heart).

Every person is different so diet and exercise might work for one person, but might not work for another. The reason for this is if you have high cholesterol, it's causing damage to the lining of your vessels, making them more narrow in places (atherosclerosis). This increases blood pressure. You can't cure that with diet and exercise; you need medications. A doctor (or nurse practitioner) would find out a patient's whole story before prescribing a medication. We'd ask about diet and exercise, how the symptoms started and when, other diseases, family history, then we'd look at bloodwork to see what's going on in their body. It's never a guess. Some blood pressure medications are better for patients with renal disease, and others are better for patients with high cholesterol.

Many doctors and nurses know about natural remedies. They are becoming more widely accepted in the medical field. They tend to be used more so as an adjunct therapy though. The most important thing is to prevent those major complications that come with hypertension.

One quick thing about antibiotics:

Yes, it's true that many doctors over prescribe antibiotics. They don't bother to find out of the patient has a virus or if it is bacterial. This is bad because it means that many antibacterial drugs are being used when they are not needed. This adds to the antibacterial resistance problem we have (as does not finishing ALL of your prescribed antibiotics). The thing is, doctors are trained to look at signs and symptoms of an infection and use their best judgement as to if a patient needs antibiotics or not. If a patient has an infection and the doctor waits for the culture and sensitivity from the lab (2-4 days), the bacterial infection is growing in your body when he is waiting. It could lead to a systemic infection, which is extremely serious. The broad spectrum antibiotics are prescribed at first because they cover many different kinds of bacteria. This could keep the infection under control while waiting for the lab results. Then the doctor will know what kinds of antibiotics will work best with that particular organism and prescribe them to you.

Potassium supplements should never be taken unless prescribed by your doctor. They can interfere with other medications. There are certain kinds of drugs where you might need to take a potassium supplement, but your blood potassium levels should be monitored closely. Low potassium (hypokalemia) or high potassium (hyperkalemia) can cause severe muscle and cardiac problems.

Oh and about type 2 diabetes: Yes many people can actually reverse their diabetes with diet and exercise. If you have type 2 diabetes and you are at the point where you are injecting yourself with insulin, than you cannot reverse is. Your pancreas makes the hormone insulin, which helps glucose (sugar) get into your cells. Your cells use glucose for energy. In type 2 diabetes, the cells become resistant to insulin so they can't let it into the cell. So, if insulin can't get in, neither can glucose. You can decrease this resistance by decreasing the amount of glucose in your blood (diet and exercise).

After a while, your pancreas tries to make a LOT of insulin because you have a LOT of glucose in your blood that isn't getting into the cells. This damages the pancreas and alters it's ability to make insulin. You have reached the point of no return. You cannot cure your diabetes, but there are many things you can do to manage it and prevent the serious side effects that go along with it (heart problems are HUGE).

Basically, we want to prevent anything terrible from happening by giving medications.

Sorry this post ended up being so long. I just wanted to get all the information out there.


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

Thanks for a very nice comment, RTalloni!


RTalloni profile image

RTalloni 4 years ago from the short journey

Thorough information on an important topic. This on hypertension should be a tremendous help to patients and caregivers alike.


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

Thank you, Pamela. I've heard about too many accidents stemming from OTCs that were bad for persons with hypertension. I don't want that for myself or anyone else, simply because we don't know. Glad this hub was helpful.


Pamela99 profile image

Pamela99 4 years ago from United States

Very well-written and thorough hub on hypertension. I have hypertension and it is probably due to all the other medications I am taking for other diseases. Fortunately, it is well controlled on medicine. I think the information you included in your hub is very important for hypertensive patients to know. Voted up and useful.


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

TDAPharm, great professional and supplemental information. Thanks for adding it. Welcome to HubPages. I look forward to reading more of your articles - cheers.


TDAPharm profile image

TDAPharm 4 years ago from Massachusetts

Great Hub. You hit a number of good points that need to be addressed by patients utilizing OTC medications for self-treatment. This is a large problem especially during cold and flu season.

Just a few things though. I agree that sprays, eyedrops, and topicals may contain drugs that have the adrenergic activity that may increase blood pressure. However, usually the absorption is local and relieves symptoms and are not absorbed systemically in a manner that can be detrimental. Of course this can be a case by case basis and I would talk to a health professional if concerned.

Also, potassium is seen often accompanying patients with hypertension being treated with diuretics due to loss of electrolytes, especially with potassium. Supplementation prevents a patient from becoming low (hypokalemia). However, potassium in a patient with an ACE inhibitor or a potassium-sparing diuretic is not recommended due to risk of developing the converse of hyperkalemia. Neither is desired, and as such when on these agents a patient may be required to perform frequent blood tests to monitor their electrolytes (eg. basic metabolic panel/BMP). As such, I would not recommend supplementation with potassium unless advised to do so.

Great Hub and keep up the good work!


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

No problem, IB R. I appreciate your point about the gamble; and I think it's a hateful thing that medicines and their side effects kill a number of people each year...because of a gamble. And, yes, it is very unfortunate thing again that our doctors have NO training in nutrition or natural remedies. How can this be!? I'd still ask because there is probably an enlightened physician out there somewhere! I've enjoyed sharing with you - cheers.


ib radmasters profile image

ib radmasters 4 years ago from Southern California

ithabise

Thanks for your detailed reply.

I understand your point about taking the medication as it does something measurable.

And if there is nothing better than the drugs for a particular case, then that is the way it has to be.

But, without knowing the root cause of any ailment then even that medication is a gamble.

It is like when a doctor prescribes a broad spectrum antibiotics without even doing blood to see if there is a bacterial infection, and what is its type. If the cause is not bacterial, then an antibiotic, especially a broad spectrum one is worthless, and could be harmful. If it is a virus, then antibiotics are not useful.

As for asking a doctor about natural remedies, they are not trained nor geared to that kind of assistance.

I do however appreciate where you are coming from on this issue, while I am being purely academic.

Thanks.


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

IB Radmasters, we know that eating a proper diet free of excess sodium, fat, and cholesterol helps hypertension; but I'm not sure doing that too often cures essential hypertension, as lifestyle change can and does eliminate Type 2 diabetes. My only concern in your statement is with "root cause of the problem": science doesn't know the root cause of hypertension. Eating healthy and using natural remedy's (some of which DON'T help, like ginkgo or St. John's Wort if taking a diuretic) is a must--with or without hypertension; and if the body could do something on its own to rectify its condition, then very possibly I wouldn't have hypertension now. But I've gone without medication, unfortunately, and the numbers go up every time, way too high. My advice would be to question doctors about the best natural assists but definitely use prescribed medication until a breakthrough is discovered. Hypertension is just too risky. Thanks for reading and an engaging comment.

(But do I believe nature's remedy's exist somewhere in the wild but will never see the light of day in a capitalistic, pharmaceutical-driven medical America? Absolutely.)


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

Chris, potassium is good for hypertension because it reduces the effects of sodium. Thanks for reading!


ib radmasters profile image

ib radmasters 4 years ago from Southern California

A very well done hub on the subject of OTC and Blood Pressure.

What about natural substance instead of drugs, like garlic, onions, green tea, oatmeal, and others.

As you say hypertension has unknown causes, so wouldn't a general healthy diet be better in the long run.

It seems like drugs, even OTC ones work on symptoms but don't really address the root cause of the problem. So in essence they are merely disrupting anything natural remedy that the body might try to do to right the anomaly.

Thanks


Chris Hugh 4 years ago

Is it true that potassium is a safe way to reduce blood pressure? I heard it's what they give to pregnant women and I wonder why it's not used more generally.


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

Rebecca, the small legwork can save a mountain of trouble or even a life. Thanks for reading and commenting--and the share!


rebeccamealey profile image

rebeccamealey 4 years ago from Northeastern Georgia, USA

Your message of reading labels and doing research about drugs that interact with Hypertension, or any condition for that matter is great advice! Thanks for the share. Voted up and shared!


ithabise profile image

ithabise 4 years ago from Winston-Salem, NC Author

I am glad it's helpful to you, Lyn. Thank you for commenting.


Lyn.Stewart profile image

Lyn.Stewart 4 years ago from Auckland, New Zealand

voted upand pressed the relevant buttons.

This is great information for people who have high blood pressure. Thanks for taking the time to share this info.

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