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High blood pressure - medicine-related

Definition

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

Alternative Names

Hypertension - medication related; Drug-induced hypertension 

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.
  • 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.

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)
  • Caffeine (including the caffeine in coffee and energy drinks)
  • Corticosteroids
  • Cyclosporine
  • Ephedra and many other herbal products
  • Erythropoietin
  • Estrogens (including birth control pills) and other hormones
  • Immunosuppressants
  • 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)
  • Testosterone and other anabolic steroids and performance-enhancing drugs
  • Yohimbe

Rebound hypertension occurs when blood pressure rises after you stop taking or lower the dose of a drug (typically a high blood pressure medicine).

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

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 www.ncbi.nlm.nih.gov/pubmed/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 www.ncbi.nlm.nih.gov/pubmed/27671491.

Victor RG. Systemic hypertension: mechanisms and diagnosis. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 43.

Review Date:10/24/2016
Reviewed By:Robert Hurd, MD, Professor of Endocrinology and Health Care Ethics, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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