Over time, the link between decongestants and hypertension, once vague and generally unconvincing, has now been conclusively proven by science. In most cases, decongestants cause high blood pressure. The introduction of decongestants for people with high blood pressure should therefore be reconsidered.
Decongestants are a type of pharmaceutical product used to relieve nasal congestion. One of those unbranded decongestants on the market that we’ve written a lot about is Benadryl.
A delay in the nasal passages can be caused by a cold or an allergic reaction, among other things. This means it is a common problem at certain times of the year.
According to the Center for Disease Control and Prevention (CDC), approximately 30 million people in the United States suffer from chronic sinusitis, which also causes nasal congestion. Other symptoms are sinusoidal headaches and a runny nose. This level of discomfort and the wretched life that results from it drives millions of people to seek help for decongestants.
To assess the effects of decongestants on blood pressure, we should start with what a typical decongestant contains. Most decongestants contain two active substances, pseudoephedrine or phenylephrine.
Both sympathomimetic drugs mimic what adrenaline, an endogenous hormone, does.
Adrenaline usually increases blood pressure, heart rate and dilates pupils when a person is in combat or flight mode. In this context, a picture emerges of the relationship between decongestants and high blood pressure.
Biological mechanism combining decongestants and hypertension
Why and how decongestants raise blood pressure is a complex biological process, but it is easier to explain.
When administered via the nose, a so-called local decongestant, decongestant receptors activate in the nasal mucosa or in the nasal cavity tissue.
Eventually it causes vasoconstriction. Vasoconstriction reduces blood flow, which on the other hand promotes the symptoms of nasal congestion.
But because the blood vessels contract, this also leads to an increase in blood pressure. Compressed blood vessels are an important element in increasing blood pressure. People suffer from high blood pressure due to increasing immobility or blockage of the blood vessels.
The fact that decongestants restrict blood flow by compressing blood vessels automatically makes it a cause of hypertension. Biological science has concluded that there is a positive correlation between decongestants and high blood pressure.
Researchers and doctors point out that oral decongestants pose the greatest risk.
While local decongestants, such as nasal sprays, tend to act locally on nasal tissue in the nose, oral decongestants act on the entire nervous system, virtually guaranteeing and increasing blood pressure.
Oral decongestants can affect the cardiovascular system, including urine, the central nervous system and the endocrine system. Taking high doses of decongestants only increases the risk of high blood pressure with dangerous consequences.
Scientific study to confirm the correlation between decongestants and hypertension
A study published in 2005 in the journal Human Hypertension showed that phenylpropanolamine, a decongestant in drugs such as cough medicines and weight control agents, significantly increased systolic blood pressure.
These results are based on a meta-analysis and review of relevant previous studies involving more than 2,100 people. Although phenylpropanolamine had no effect on pulse, systolic blood pressure (upper number) increased by 5.5 mmHg and diastolic blood pressure (lower number) by 4.1 mmHg.
Although these changes can be considered minor, other studies have shown that even small changes in blood pressure lead to very high cardiovascular risks. That is why we cannot ignore the smallest change, be it positive or negative.
The study report also found that some participants in the clinical trials had a blood pressure in excess of 35 mmHg at systolic blood pressure. These people had a normal blood pressure, which increased dramatically under the influence of the decongestant.
The Human Hypertension Magazine study concluded that short-term administration of the decongestant phenylpropanolamine resulted in both increased blood pressure and higher doses. People with controlled hypertension are less likely to develop hypertension after taking phenylpropanolamine.
Pubmed Health notes that decongestants such as phenylephrine, when injected, are effective in treating hypotension, or abnormally low blood pressure. This suggests that decongestants are effective in raising blood pressure, making them useful in the treatment of abnormally low blood pressure.
Interaction of decongestantsand antihypertensives
The mechanism underlying the decongestants and the way they lead to hypertension represents the possibility of interaction between the decongestants and the drugs used to treat hypertension.
Antihypertensives have a relaxing or vasodilating effect, for example by lowering blood pressure. On the other hand, as said, decongestants have the opposite effect: they constrict the blood vessels, leading to an increase in blood pressure.
This interaction between decongestants and antihypertensives can take different forms. Decongestants can cause high blood pressure medication to be set to zero, resulting in uncontrolled blood pressure. Depending on the circumstances, this can be remedied by increasing the dose of the relevant blood pressure medication.
The link between high blood pressure and decongestants, as shown here, has been scientifically proven. People with high blood pressure should be careful when using the different types of sympathomimetic drugs available on the market.
The information on this website is not intended to replace medical advice.
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You can also see our results on Benadryl, a decongestant and antihistamine, which is a very popular seasonal remedy for allergies and the inevitable clogging of the nose in every winter season. For more information, click here.
Treatment of a cold during pregnancy
There are too many things you can’t do without during pregnancy, and pharmacological drugs are one of them. And if you’re pregnant and you have a cold, how can that happen? Most over-the-counter medications contain decongestants in their active ingredients.
In our editorial we already made the connection between decongestants and high blood pressure. So there is a risk, especially considering the risk of high blood pressure during pregnancy. The most recommended decongestants are nasal sprays, because they are localized and the vessels are not compressed throughout the body, which increases blood pressure.
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