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Drug-induced hypertension

Definition

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

Alternative Names

Hypertension - medication related

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 medication.

Drugs that can cause hypertension include:

  • Acetaminophen
  • Alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine
  • Antidepressants (including venlafaxine, bupropion, and desipramine)
  • Caffeine (including the caffeine in coffee and energy drinks)
  • Corticosteroids
  • Cyclosporine
  • Erythropoietin
  • Estrogens (including birth control pills) and other hormones
  • Many over-the-counter medications such as cough/cold and asthma medications -- particularly when the cough/cold medicine is taken with certain antidepressants like tranylcypromine or tricyclics
  • Migraine medications
  • Nasal decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) 

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

Many other factors can also affect blood pressure, including:

  • Condition of the kidneys, nervous system, or blood vessels
  • Genetics
  • Foods eaten, weight, and other body-related variables
  • Levels of various hormones in the body
  • Volume of water in the body

References

Grossman G, Messerli FH. Drug-induced hypertension: An unappreciated cause of secondary hypertension. Am J Med. 2012;125:14-22.

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; 2014:chap 43.

Review Date:11/25/2014
Reviewed By:Robert Hurd, MD, Professor of Endocrinology and Bioethics at Xavier University, Cincinnati, Ohio. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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