Health Encyclopedia

High blood pressure - medicine-related

Definition

Drug-induced hypertension is high blood pressure caused by a chemical substance or medicine.

Alternative Names

Hypertension - medication related; Drug-induced hypertension

Causes

Blood pressure is determined by the:

Amount of blood the heart pumps
Condition of the heart valves
Pulse rate
Pumping power of the heart
Size and condition of the arteries

There are several types of high blood pressure:

Essential hypertension has no cause that can be found (many different genetic traits contribute to essential hypertension, each one having a relatively small effect).
Secondary hypertension occurs because of another disorder.
Drug-induced hypertension is a form of secondary hypertension caused by a response to a chemical substance or medicine.
Pregnancy-induced hypertension.

Chemical substances and medicines that can cause high blood pressure include:

Acetaminophen
Alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine
Angiogenesis inhibitors (including tyrosine kinase inhibitors and monoclonal antibodies)
Antidepressants (including venlafaxine, bupropion, and desipramine)
Black licorice
Caffeine (including the caffeine in coffee and energy drinks)
Corticosteroids and mineralocorticoids
Ephedra and many other herbal products
Erythropoietin
Estrogens (including birth control pills)
Immunosuppressants (such as cyclosporine)
Many over-the-counter medicines such as cough/cold and asthma medicines, particularly when the cough/cold medicine is taken with certain antidepressants, such as tranylcypromine or tricyclics
Migraine medicines
Nasal decongestants
Nicotine
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Phentermine (a weight loss medicine)
Testosterone and other anabolic steroids and performance-enhancing drugs
Thyroid hormone (when taken in excess)
Yohimbine (and Yohimbe extract)

Rebound hypertension occurs when blood pressure rises after you stop taking or lower the dose of a drug (typically a medicine to lower high blood pressure).

This is common for medicines that block the sympathetic nervous system like beta blockers and clonidine.
Talk to your health care provider to see if your medicine needs to be gradually tapered before stopping.

Many other factors can also affect blood pressure, including:

Age
Condition of the kidneys, nervous system, or blood vessels
Genetics
Foods eaten, weight, and other body-related variables, including the amount of added sodium in processed foods
Levels of various hormones in the body
Volume of water in the body

References

Bobrie G, Amar L, Faucon A-L, Madjalian A-M, Azizi M. Resistant hypertension. In: Bakris GL, Sorrentino MJ, eds. Hypertension: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 43.

Charles L, Triscott J, Dobbs B. Secondary hypertension: discovering the underlying cause. Am Fam Physician. 2017;96(7):453-461. PMID: 29094913 pubmed.ncbi.nlm.nih.gov/29094913/.

Grossman A, Messerli FH, Grossman E. Drug induced hypertension--an unappreciated cause of secondary hypertension. Eur J Pharmacol. 2015;763(Pt A):15-22. PMID: 26096556 pubmed.ncbi.nlm.nih.gov/26096556/.

Jurca SJ, Elliott WJ. Common substances that may contribute to resistant hypertension, and recommendations for limiting their clinical effects. Curr Hypertens Rep. 2016;18(10):73. PMID: 27671491 pubmed.ncbi.nlm.nih.gov/27671491/.

Peixoto AJ. Secondary hypertension. In: Gilbert SJ, Weiner DE, Bomback AS, eds. National Kidney Foundation Primer on Kidney Diseases. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 65.

Review Date:11/3/2022
Reviewed By:Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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