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Drug-induced hypertension: Know the problem to know how to deal with it

Stefano Masi1, Monica Uliana2, Marco Gesi3

  • 1Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Vascular Pharmacology
|March 2, 2019
PubMed

Insights

Drug-induced hypertension is a significant barrier to controlling high blood pressure, impacting millions globally. This review examines medications that elevate blood pressure and suggests appropriate antihypertensive strategies.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Arterial hypertension is a primary global mortality risk factor.
  • Many patients do not achieve target blood pressure control despite treatment.
  • Drug-induced hypertension contributes to this treatment gap.

Purpose of the Study:

  • To review medications and substances that elevate blood pressure.
  • To identify mechanisms by which these agents increase blood pressure.
  • To recommend antihypertensive strategies when drug withdrawal is not feasible.

Main Methods:

  • Literature review of pharmacological agents and substances affecting blood pressure.
  • Analysis of mechanisms including sodium/water retention, vasoconstriction, and sympathomimetic activation.
  • Synthesis of evidence to guide antihypertensive selection.

Main Results:

  • Numerous medications and substances can induce or worsen hypertension.
  • Mechanisms involve fluid retention, direct vasoconstriction, and sympathetic nervous system activation.
  • Specific antihypertensive classes may be more effective in managing drug-induced hypertension.

Conclusions:

  • Drug-induced hypertension is a critical factor in suboptimal blood pressure management.
  • Understanding these drug interactions is essential for effective hypertension treatment.
  • Tailored antihypertensive therapy is necessary when causative agents cannot be discontinued.

Keywords:
CyclosporineDrug-induced hypertensionMedicationsSympathomimetic activation

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