Uncontrolled or poor control of blood pressure (BP) in some patients with hypertension may be due to the use of medications that increase BP, suggests a study reported in JAMA Internal Medicine.

The cross-sectional study examined data from 27,599 adults in the National Health and Nutrition Examination Survey (NHANES) to find out the medications used that were associated with rise in BP. The survey was conducted in cycles between 2009 and 2018. About half of the participants were women. Systolic BP ≥130 mm Hg or diastolic ≥80 mm Hg was considered as hypertension. The medication use was self-reported.

About 49.2% study subjects were hypertensive and 35.4% had uncontrolled hypertension. Among patients with hypertension, 18.5% were found to use at least one medication that could raise the BP. Antidepressants (8.7%), prescription nonsteroidal anti-inflammatory drugs (NSAIDs) (6.5%), steroids (1.9%) and estrogens (1.7%) were among the most commonly used drugs. Those who were not on any antihypertensive treatment had higher odds of having uncontrolled hypertension if they were taking these drugs (OR 1.24).

This study has analyzed the use and impact of polypharmacy on control of BP in hypertensive adults. It has also identified some drugs that are implicated in poor control of BP and further add to polypharmacy creating a vicious cycle. Instead of simply prescribing another antihypertensive to achieve target BP, the physician should review their use of OTC and prescription medications and consider stopping those medications that increase the BP or replace them with safer alternatives or reduce the dose, as appropriate.

Reference

1. Vitarello JA, et al. Prevalence of medications that may raise blood pressure among adults with hypertension in the United States. JAMA Intern Med. 2021 Nov 22. doi: 10.1001/jamainternmed.2021.6819.