Is medication making your hypertension worse?

Daily medication is critical for the health of millions of Americans. But even as pills, ointments and injections treat one condition, they can make others worse.

A new study from JAMA Internal Medicine makes that clear. It found that an alarming number of adults take medications that can increase blood pressure.

The study included 28,000 people. Among them, 15% of all participants and 19% of those with hypertension (high blood pressure) were using medications known to drive up blood pressure. And the researchers looked only at prescription medications. If you factor in over-the-counter pain pills and cold medicines, the true number is likely higher.

“Every medication has the potential to cause side effects,” says Benjamin Weber, MD. He’s a cardiologist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. “Balancing the benefits and risks in the context of each patient’s unique situation is an essential part of a physician’s job.”

In other words, sometimes taking a medication that increases blood pressure is the best option, since it helps you in other ways. That’s especially true for people who are treating multiple health conditions, says Dr. Weber.

But at the same time, if you have high blood pressure, you may want to explore whether there are ways to treat your other health conditions without putting extra pressure on your arteries. And that starts by identifying the problem.

While you’re at it, have a look at how much you’re paying for medication. Optum Perks may be able to bring the price down. Download our mobile app and you’ll be able to search for medication discounts at pharmacies in your area.

Medicines that may raise your blood pressure

If you’re taking medications for conditions unrelated to high blood pressure, it’s smart to check whether any of them are on this list. If they are, they could be putting a strain on your arteries.

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac® and Sarafem®) are common. But there are other antidepressants to consider as well. Those include monoamine oxidase inhibitors, tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs).
  
• Anti-inflammatory medications: These include both corticosteroids, such as prednisone and cortisone, and nonsteroidal anti-inflammatory drugs (NSAIDs).In the NSAID category, you’ll find the arthritis medication indomethacin (Indocin®, Tyvorbex®) and over-the-counter pain relievers such as naproxen (Aleve®) and ibuprofen (Advil®, Motrin IB®).
  
• Cough medicines and decongestants: Cough and cold medications narrow blood vessels inside your nose, according to the Mayo Clinic. That can be good for sniffles, but it can also constrict blood vessels elsewhere in your body.
  
• Some oral contraceptives: The estrogen found in some birth control medications can increase your blood pressure, according to researchers at Cedars-Sinai Medical Center in Los Angeles. For women with high blood pressure, they recommend sticking to contraceptives with progestin only. (Use our search tool to find discounts on birth control.)
  
• Stimulants: Think methylphenidate (Ritalin®), dextroamphetamine-amphetamine (Adderall®) and dextroamphetamine (Dexedrine®). Stimulants are often prescribed for attention deficit hyperactivity disorder (ADHD) or sleep conditions such as narcolepsy.

What should you do if your medication is increasing your blood pressure?

If you’re regularly testing your blood pressure and know it’s in a healthy range, you might not have a problem. But if your blood pressure is high or you’re unsure, talk to your prescriber, says Dr. Weber. You may be able to switch to a different prescription or reduce your dose.

One easy way to handle this, Dr. Weber says, is with a comprehensive medication review. This process allows a doctor or pharmacist to look over all your medications and supplements to find potential interactions, redundancies or side effects.

A comprehensive medication review can be especially helpful for people who are under the care of multiple doctors from different health systems, says Dr. Weber.

But one important note: Don’t stop taking a medication until you’ve spoken to your doctor. “Your doctor likely prescribed your medication for an important reason,” says Dr. Weber. “Discontinuing it without a plan in place could have consequences.”

Recommended reading: Why are there so many types of blood pressure medication?

Natural ways to reduce your blood pressure

One effective strategy for balancing a medication’s effect on blood pressure is to deploy some healthy lifestyle habits. This strategy could help millions of people, says David D’Agate, DO. He’s a cardiologist at St. Francis Hospital Suffolk Heart Group and practices at St. Catherine of Siena Hospital in Smithtown, New York.

“Hypertension is really an epidemic in the U.S.,” says Dr. D’Agate. “A lot of people are on medication to treat high blood pressure. The question is whether there is anything you can do to lower your blood pressure.”

The answer: yes. Here are Dr. D’Agate’s recommendations:

Sniff out hidden sources of salt

Sodium, or salt, is a primary culprit when it comes to high blood pressure. But it can be hard to control — or even know — how much sodium you’re eating.

“People tend to eat foods that have a lot of salt, and they have no idea how much they’re eating,” Dr. D’Agate says. “Breads, cold cuts, soups and frozen meals can all be high in sodium.” The biggest offenders are restaurant and fast-food meals; canned and frozen foods; and condiments such as hot sauce.

“A few simple lifestyle changes, such as avoiding these foods, can dramatically lower your blood pressure,” says Dr. D’Agate. “It can possibly even eliminate the need for blood pressure medicines altogether.”

If you need more dietary guidance, consider following the DASH diet. It was designed specifically for heart health.

Monitor your pressure

Buy a blood pressure cuff to keep a close eye on your blood pressure at home.

“The best time to measure is once in the morning and once at night,” says Dr. D’Agate. “To take your blood pressure, you should be seated at a table with your feet uncrossed and on the ground. Your arm should be level with your heart.” (Here’s how to read your blood pressure.)

Drop the extra weight

If your weight has been ticking upward for the past few years, it’s time to create a plan for getting back to a healthy range. “For every 2 pounds we lose, we lower our systolic blood pressure by 1 point,” Dr. D’Agate says. “That’s as good as you’ll get with some medicines.”

Exercise daily

This, along with a healthy diet, can have a big impact on your weight and heart health. “If you exercise for 30 minutes a day, you can lower your systolic blood pressure by up to 8 points,” Dr. D’Agate says. (Click here for more ways to lower your blood pressure.)

If lifestyle changes alone don’t bring your blood pressure down into a healthy range, a change to your medication regimen may be the solution. “Frequently, adding an antihypertensive medication is the correct treatment,” says Dr. D’Agate. “But sometimes, taking away a problematic medication can be just as effective.”

And don’t forget: Optum Perks might be able to help you save money. Present our discount card at the pharmacy to see if you can find a lower price. In some cases, the savings are as much as 80%.