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Many medications can contribute to secondary hypertension: common prescription and over-the-counter drugs may raise your blood pressure.

The medications you take for colds and headaches also may be causing your blood pressure to rise. When hypertension (high blood pressure) is caused by medications or a medical condition, such as thyroid disease, it's considered secondary hypertension. It can develop in people whose blood pressure is usually in the normal range, or it can occur along with primary hypertension.

Primly, or essential hypertension is the most common form of high blood pressure; it has no specific, identifiable cause, although many known risk factors can increase your likelihood of having it. These include a family history of high blood pressure, being obese, eating a high-salt diet, and advancing age. Race also may play a role; African Americans, for example, are at a higher risk than Caucasians for primary hypertension.

Treatment options

Fortunately, secondary hypertension that is caused by medication often can be treated successfully. Phyllis August, MD, director of the Hypertension Center at Weill Cornell Medical Center, says a change in medications or lifestyle adjustments may be enough to corral secondary hypertension.

"If your high blood pressure is caused by a medication, then you need to consider alternatives to the offending medication; if you also have primary hypertension, your antihypertensive therapy may need to be increased," she says, adding that patients also should consider steps such as lowering the sodium in their diets. Some people are more "salt-sensitive than others, meaning their blood pressure responds more dramatically to increases or decreases in salt intake.

"Offending" medications

The medications that can cause secondary hypertension may surprise you. They include over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Morrin, Advil), and naproxen (Anaprox, Aleve). NSAIDs' effects on blood pressure may be related to their potential to cause the kidneys to increase sodium and water retention, which can cause fluid levels, including blood volume, to rise throughout the body.

"If you take NSAIDs for chronic pain, you should discuss other pain-relief options with your doctor," Dr. August says. Alternatives include acetaminophen (Tylenol) or non-pharmacological approaches, including physical therapy, biofeedback, yoga, and acupuncture.

Another common medication that can cause secondary hypertension is pseudoephedrine, a key ingredient in many over-the-counter cold medicines. Pseudoephedrine causes blood vessels to constrict, resulting in an increase in blood pressure.

Medications that contain estrogen, such as hormone therapy, may contribute to secondary hypertension, Dr. August says. Steroid medications used to treat pain and inflammation also may increase blood pressure. (See chart for more details.)

Know the risks

For medications known to raise blood pressure and cause other potentially harmful side effects, warning labels usually describe such risks. Dr. August recommends reading labels carefully, and asking your doctor and pharmacist about whether the medications pose a hypertension risk. If a prescribed medication or an over-the-counter drug lists high blood pressure as a potential side effect, ask about an alternative option. This is especially important if you're already dealing with primary hypertension.

Hypertension, be it secondary or primary, is a major risk for stroke, heart failure, and kidney problems, so it is essential to work with your doctor to reduce your risks by bringing down your blood pressure.

RELATED ARTICLE: MEDICATIONS THAT MAY CAUSE SECONDARY HYPERTENSION

Pseudoephedrine, an ingredient in many cold/sinus/flu and allergy medications

Steroid drugs

Nonsteroidal anti-inflammatory drugs Cyclosporine, an immunosuppressant Erythropoietin, which stimulates red blood cell formation Estrogen in hormone therapies

Brand names include Actifed, Advil, Aleve, Alka-Seltzer, Claritin, Contac, Dristan, Dimetapp, Robitussin, Sudafed, Tylenol, Theraflu, Vicks, Zyrtec, and others

Cortisone, hydrocortisone, prednisone, dexamethasone, and others

Ibuprofen (Advil, Motrin), naproxen (Anaprox, Aleve)

Procrit, also called epoetin alfa

Enjuvia, Estrace, Premarin;

Ortho-Est, Vivelle, Climara Pro, Prempro, Duavee, and others

RELATED ARTICLE: WHAT YOU SHOULD KNOW

These conditions may cause secondary hypertension:

* Thyroid disease

* Kidney disease

* Kidney damage due to diabetic nephropathy

* Sleep apnea

* Primary aldosteronism (overproduction of the hormone aldosterone, which creates an imbalance of sodium and potassium)

* Cushing's disease (overproduction of the hormone cortisol)
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Publication:Women's Health Advisor
Date:Jan 1, 2015
Words:650
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