Over the counter blood pressure medications
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Over-the-Counter Blood Pressure Medications: Common Types and Usage
Over-the-counter (OTC) medications are widely used by people with hypertension, often without medical supervision. Analgesics like acetaminophen, vitamins, minerals, herbal supplements, and drugs for minor illnesses are among the most commonly used OTC products by hypertensive patients 56. Some individuals also use OTC antihypertensive medications and complementary and alternative medicines (CAMs), such as herbs, in an attempt to manage their blood pressure .
Impact of OTC Medications on Blood Pressure Control
Acetaminophen and Blood Pressure
Acetaminophen, a popular OTC pain reliever, has been shown to increase systolic blood pressure in both the general population and in people with hypertension, although it does not significantly affect diastolic blood pressure 12. This finding raises concerns about the safety of regular acetaminophen use, especially for those with pre-existing hypertension or cardiovascular risk factors .
Other OTC Substances That Affect Blood Pressure
Several other OTC drugs and substances can raise blood pressure or interfere with blood pressure control. These include non-steroidal anti-inflammatory drugs (NSAIDs), sympathomimetic amines (found in some cold and allergy medications), estrogen-containing oral contraceptives, certain antidepressants, and herbal products like ephedra 37. Long-term use of nasal decongestants, which are available OTC, has also been linked to persistent hypertension, as demonstrated in a clinical case where discontinuing the decongestant led to normalization of blood pressure .
Activated charcoal, another OTC product, can inactivate antihypertensive medications, making blood pressure difficult to control and potentially leading to misdiagnosis of resistant hypertension .
Prevalence and Awareness of OTC Medication Use in Hypertensive Patients
A significant proportion of people with hypertension regularly use OTC drugs and dietary supplements, with studies showing that up to two-thirds of hypertensive patients report regular use 56. However, many are unaware of the potential interactions between these substances and their prescribed antihypertensive medications, and only a minority consistently consult their doctors about OTC use . This lack of awareness can lead to poor blood pressure control and increased cardiovascular risk 367.
The Importance of Medication Review and Patient Education
Healthcare professionals should routinely ask about OTC medication and supplement use when managing patients with hypertension, as these substances can contribute to elevated blood pressure or reduce the effectiveness of prescribed treatments 378. Patients should be educated about the potential risks of self-medicating with OTC products and the importance of discussing all medications, including nonprescription ones, with their healthcare provider 56.
Conclusion
OTC medications and supplements are commonly used by people with hypertension, but many of these substances can raise blood pressure or interfere with prescribed antihypertensive drugs. Acetaminophen, NSAIDs, nasal decongestants, and certain herbal products are particularly important to monitor. Both patients and healthcare providers should be vigilant about the use of OTC products to ensure safe and effective blood pressure management.
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