Drugs for cough and cold symptoms in hypertensive patients

Most cold preparations contain sympathomimetic decongestants in combination with antihistamines, anticholinergics or expectorants. All of the sympathomimetic decongestants have the potential to elevate blood pressure, yet little information has been reported on their use in patients with hypertension. Phenylephrine and phenylpropanolamine stimulate alpha-adrenergic receptors, causing elevation of blood pressure and a reflex decrease in heart rate. Ephedrine and pseudoephedrine stimulate both alpha and beta receptors, elevating blood pressure with an increase or no change in heart rate. Because little is clinically known, these agents should probably be avoided in hypertensives.