Normal blood pressure is less than 130 systolic (when the heart pumps blood) and 85 diastolic (when the heart is resting or in between beats). Hypertension is clinically defined as a systolic pressure consistently at 140 or higher and a diastolic pressure consistently at 90 or higher. According to the National Heart, Lung, and Blood Institute (NHLBI), 50 million Americans are diagnosed with hypertension, or high blood pressure, and another 15 million are undiagnosed.
Left untreated, hypertension can lead to serious complications, including:
- Heart attacks
- Congestive heart failure
- Heart damage
- Blood vessel damage
- Brain damage
- Kidney damage
- Loss of vision
Hypertension is a factor in 75 percent of all first strokes and 68 percent of all first heart attacks.
Blood pressure is determined by several factors, including:
- The amount of blood that is pumped by the heart
- The heart’s pumping power
- The condition of the heart valves
- The size and condition of the arteries
- The volume of water in the body
- Body weight and foods eaten
- The condition of the kidneys, blood vessels, and nervous system
- The levels of various hormones in the body
There are several kinds of high blood pressure. Essential hypertension occurs in most of us at some point in our lives and has no identifiable cause. Secondary hypertension occurs as the result of another disorder. Drug-induced hypertension is a type of secondary hypertension resulting as a response to medication.
Attempts to establish the cause of hypertension often include blood tests to determine the level of suspect medications, and a review of the patient’s medical history. Drug-induced or medication related hypertension can be caused by using a drug, medication or chemical substance. But it can also be caused by discontinuing the use of a drug or medication (also known as rebound hypertension).
Drugs and medications that can cause hypertension include:
- Alcohol, ecstasy (MDMA and derivatives), amphetamines, and cocaine
- Estrogens (including birth control pills such as Ortho Evra) and other hormones
- Migraine medications
- COX-2 inhibitors such as rofecoxib (VIOXX), celecoxib (CELEBREX), and valdecoxib (BEXTRA), which was pulled from the market in 2005
- Erythropoietin (used to correct anemia related to chronic diseases such as cancer, kidney failure, and HIV)
- Nasal decongestants
- Many over-the-counter medications such as cough, cold, and asthma medications, specially when combined with certain antidepressants like tricyclics and tranylcypromine
- High blood pressure medications, such as clonidine). Also dangerous when a person discontinues taking them
Hypertension usually does not show any obvious symptoms. The following symptoms may appear if the hypertension is severe:
- Chest pain
- Changes in vision
- Nausea and vomiting
- Excessive perspiration
- Shortness of breath
- Red or pale skin
- Muscle tremors
If identified, the substance that caused the drug-induced hypertension is discontinued unless it is not advisable (as when clonidine is involved). Medical therapy for the primary condition may have to be adjusted.
To modify the blood pressure, the following drugs may be considered:
- Beta blockers
- Calcium channel blockers
- Potassium replacements
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers (ARB)
Following any treatment, the blood pressure should be monitored at regular intervals. A change in lifestyle, including weight loss, reduced sodium intake (including products containing salt, baking soda, and MSG), exercise, and reduced alcohol consumption may be recommended. Persistent high blood pressure levels will likely require regularly scheduled appointments with a physician. If any of the symptoms listed appear, the physician should be contacted immediately.
Special care will need to be taken before any substance or medication. A pharmacist or doctor should be consulted before taking any medication that may interact with medications already being taken.