People who take drugs to lower their blood pressure often take also blood pressure-interfering drugs that reduce the pills’ effectiveness: the most prevalent are nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophens, and hormones, a recent study suggests.

Researchers identified 521,028 patients with incident hypertension and 131,764 patients with incident treatment-resistant hypertension (TRH).

The research included adults, aged 18–65 years, with a hypertension diagnosis and =1 antihypertensive medication fill.

Two hypertension cohorts were examined: new antihypertensive drug users (incident hypertension) and patients requiring titration to a fourth antihypertensive (incident treatment-resistant hypertension).

Patient-level exposure to blood pressure-interfering medications was assessed 6 months before and after the index date, defined as the first prescription fill of an antihypertensive drug or the first occurrence of overlapping use of =4 antihypertensive drugs.

Overall, 18.3% of the incident hypertension cohort and 17.6% of the incident TRH cohort initiated a blood pressure-interfering medication following antihypertensive titration.

Among patients previously taking a blood pressure-interfering medication, 57.6% with incident hypertension and 64.9% with incident TRH refilled that medication after antihypertensive intensification.

Some drugs, such as NSAIDs and hormones, elevate blood pressure mainly by causing the body to retain excess fluid and this effect counteracts the mechanism of some blood pressure medications like diuretics which cause the body to get rid of fluid.

Other drugs can elevate blood pressure by constricting the blood vessels, increasing heart rate, or by a combination of mechanisms.

Some other drugs, such as acetaminophen, increase blood pressure, and we don’t know how.

But if blood pressure drugs are not working, it’s important to consider not just other drugs that might influence blood pressure but also herbal medications that often are considered harmless.

The study, published in the American Journal of Hypertension, wasn’t designed to prove whether or how certain prescription drugs might interfere with the effectiveness of blood pressure medicines or increase blood pressure.

Another limitation is that it focused only on patients who were taking prescribed medicines that can interfere with blood pressure drugs, and many painkillers like acetaminophen and naproxen are available over the counter without a prescription in the U.S., the study authors note.

For more information
American Journal of Hypertension
Use of Prescription Medications That Potentially Interfere With Blood Pressure Control in New-Onset Hypertension and Treatment-Resistant Hypertension

High Point University

University of Florida


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