6 Common Drugs That Affect Blood Pressure

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most popular over-the-counter medicines in the world today. They are used to treat headaches, reduce fever, and, when taken in higher doses, alleviate pain and inflammation.

While NSAIDs are typically safe, prolonged use can lead to alterations in blood pressure. This is because NSAIDs can cause sodium and water retention which, over time, can lead to increased blood pressure. Long-term use has also been linked to changes in kidney function, the organ of which is key to blood pressure regulation.

NSAIDs of concern include ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn).

Tylenol (acetaminophen) is used to treat many of the same symptoms as ibuprofen and naproxen but works in a different manner. As a non-aspirin analgesic, it has a chemical structure separate to that of NSAIDs and also tends to have a lesser effect on inflammation.

While generally safe, one of the concerns about Tylenol is its effect on the liver. Long-term use or overuse can cause liver damage, which, in turn, can lead to a condition called portal hypertension. With portal hypertension, blood pressure increases in the liver translate to increases throughout the body.

When used appropriately, Tylenol will tend to have a lesser impact on blood pressure when compared to NSAIDs. However, alcohol should be avoided when taking acetaminophen as this can increase the likelihood of liver problems.

Decongestants work by slowing the production of mucus which can clog breathing passages. The drugs achieve this by causing the constriction of blood vessels in the nose and sinuses, opening airways and reducing the sensation of fullness caused by allergies or colds.

Most decongestants contain either pseudoephedrine or phenylephrine, stimulants known to increase blood pressure. When used appropriately over a short period of time, decongestants are largely safe and effective.

However, overuse or long-term use may be problematic, potentially increasing blood pressure and undermining anti-hypertensive treatment. Non-stimulant decongestants are available and may be just as effective in treating certain nasal conditions.

Drug stores carry dozens of pills, syrups, and tablet designed to ease cold and flu symptoms. While each has different formulations, they are largely comprised of the same or similar basket of ingredients.

Some multi-symptom remedies contain decongestants and cough suppressants to help clear nasal passages and ease breathing. Ibuprofen or acetaminophen may be included to relieve muscle aches and fever. Each of these can, directly and indirectly, alter a person's blood pressure.

Some, like decongestants, cause blood vessels to constrict. Others change how the body handles things like salt and water, leading to fluid retention and increased blood pressure. This combined effect can cause short-term increases that may counteract the effectiveness of your anti-hypertensive drugs.

Virtually all hormonal birth control pills, patches, and devices are associated with increased blood pressure. Vascular constriction is a common side effect of these products, particularly among women who smoke, are overweight, or are over the age of 35. Not all women will be affected, but, if you have underlying hypertension, you will need to be monitored closely, ideally every six to 12 months.

Alternately, oral contraceptives with lower-dose estrogen may mitigate some of the blood pressure effects. If not, you may need to consider other forms of birth control.

Antidepressants work by altering chemicals in the body associated with mood, including serotonin and dopamine. Both of these compounds are known to affect pressure. Dopamine is often used in emergency situations to increase blood pressure in those experiencing a critical drop. Serotonin has a similar effect which may further enhance dopamine's effect on the cardiovascular system.

Several types and classes of antidepressant drugs have been linked to this effect, including venlafaxine, tricyclic antidepressants, and fluoxetine.