Could These Medications Be Raising Your Blood Pressure?

If you're managing your health after age 50, you may be taking one or more prescription or over-the-counter drugs for chronic conditions like arthritis, allergies, or mood disorders. While these medications help treat specific symptoms, some of them can quietly affect your blood pressure—sometimes raising it without clear warning signs. Certain medications that raise blood pressure are more common than many people realize, and their effects can be especially important for adults over 50, who are already at higher risk for hypertension and cardiovascular complications.

High blood pressure (often called "the silent killer") affects nearly half of all adults in the U.S., and many don’t know they have it because it often causes no symptoms. A common misconception is that only prescription heart medications matter when monitoring blood pressure—but everyday remedies like nasal decongestants or anti-inflammatory pain relievers can also play a role. Another myth is that if a drug is available without a prescription, it must be safe for everyone. In reality, even OTC products can interfere with your body’s ability to regulate blood pressure, especially if used long-term or in combination with other medications.

Understanding which drugs might contribute to elevated readings empowers you to take control of your heart health. Let’s explore the most common categories of medicines linked to increased blood pressure, how to identify potential risks, and what steps you can take alongside your doctor.

Common Medications That Raise Blood Pressure

Many drugs influence blood pressure through mechanisms such as fluid retention, constriction of blood vessels, or interference with hormone systems that regulate arterial pressure. Here are some of the most frequently used types of medications that raise blood pressure, along with how they work:

1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve) are widely used for joint pain, headaches, and inflammation. However, regular use—even for just a few days—can lead to increased blood pressure, particularly in older adults. NSAIDs reduce kidney function slightly, causing the body to retain salt and water. This increases blood volume and, consequently, blood pressure. Studies suggest that NSAID use may raise systolic BP by 3–5 mm Hg on average, but in sensitive individuals, increases up to 10 mm Hg have been observed.

Who should be cautious: People with existing hypertension, heart failure, or kidney disease should limit NSAID use unless directed otherwise by a doctor.

2. Decongestants

Found in many cold, allergy, and sinus relief products (like pseudoephedrine and phenylephrine), decongestants tighten blood vessels to reduce nasal swelling. Unfortunately, this effect isn’t limited to the nose—it can also constrict blood vessels throughout the body, leading to elevated arterial pressure. For someone with well-controlled hypertension, even a short course of a decongestant can push readings into an unsafe range (above 140/90 mm Hg).

Tip: Look for “non-drowsy” formulas—they’re more likely to contain stimulant-like decongestants. Opt instead for saline sprays or antihistamines labeled as non-decongestant (e.g., loratadine, cetirizine).

3. Antidepressants

Some classes of antidepressants, particularly tricyclic antidepressants (TCAs) like amitriptyline and monoamine oxidase inhibitors (MAOIs), can increase blood pressure. Even certain SSRIs and SNRIs may have modest effects, though usually less pronounced. These drugs alter neurotransmitters that influence vascular tone and heart rate. Older adults on long-term treatment for depression or nerve-related pain (such as diabetic neuropathy) should be monitored regularly.

4. Steroid Medications

Prednisone and other corticosteroids—commonly prescribed for asthma, rheumatoid arthritis, or autoimmune conditions—can significantly impact blood pressure. They cause sodium retention and potassium loss, increasing fluid volume and straining the cardiovascular system. Long-term steroid users may see gradual rises in BP over weeks or months, making routine checks essential.

5. Hormonal Treatments

Estrogen-containing medications, including some birth control pills and hormone replacement therapy (HRT), have been associated with mild to moderate increases in blood pressure, especially in women over 50. The mechanism involves changes in fluid balance and vascular resistance. While modern low-dose formulations pose lower risks, monitoring is still recommended.

Other less obvious contributors include:

• Immunosuppressants like cyclosporine and tacrolimus (used post-transplant)
• Erythropoietin-stimulating agents (for anemia)
• Weight-loss drugs containing stimulants (e.g., phentermine)
• Energy supplements or herbal products with ephedra-like compounds (banned in many forms, but still present in some imported products)

Why Drug-Induced Blood Pressure Changes Matter

Even small increases in blood pressure can add up over time. A sustained rise of just 5 mm Hg in systolic pressure is linked to a 20% higher risk of heart disease and stroke. For people already managing hypertension, adding a medication that raises blood pressure—even temporarily—can undo progress made through lifestyle changes or antihypertensive drugs.

Certain groups should pay extra attention:

• Adults aged 50 and older, due to natural stiffening of arteries with age
• Those with a family history of high blood pressure or cardiovascular disease
• Individuals with diabetes, chronic kidney disease, or obesity
• People taking multiple medications ("polypharmacy"), where interactions are more likely

It’s also important to remember that not everyone reacts the same way. One person might take a daily NSAID with no change in BP, while another sees a sharp spike. That’s why personalized care and regular monitoring are key.

Your pharmacist or doctor can review your full medication list—including supplements and occasional OTCs—to assess potential contributors. Never stop a prescribed medication abruptly; always consult your provider before making changes.

Practical Steps to Protect Your Heart Health

Managing your blood pressure isn’t just about avoiding risky medications—it’s about building habits that support overall cardiovascular wellness. Here are evidence-based strategies to stay proactive:

1. Review All Medications Regularly

At every doctor’s visit, bring a complete list of:

• Prescription drugs
• Over-the-counter medications
• Vitamins, herbs, and dietary supplements

Ask specifically: “Could any of these affect my blood pressure?” This simple question can uncover hidden risks.

2. Choose Safer Alternatives When Possible

For pain relief:

• Use acetaminophen (Tylenol) instead of NSAIDs, if appropriate for your liver health
• Try topical treatments (creams, patches) for localized joint pain

For allergies:

• Use intranasal corticosteroid sprays (e.g., fluticasone) or non-sedating antihistamines without decongestants
• Avoid combination products labeled “D” (e.g., Claritin-D)—the “D” stands for decongestant

3. Monitor Your Blood Pressure at Home

Home monitoring helps detect changes early. To get accurate results:

• Use an upper-arm cuff monitor (more reliable than wrist devices)
• Sit quietly for 5 minutes before measuring
• Keep your arm supported at heart level
• Take readings at the same time each day, ideally morning and evening
• Record two or three measurements, spaced 1–2 minutes apart

Normal blood pressure is below 120/80 mm Hg. Readings consistently above 130/80 mm Hg may indicate a need for medical review.

4. Adopt Heart-Healthy Lifestyle Habits

• Eat a balanced diet: Focus on fruits, vegetables, whole grains, lean proteins, and low-fat dairy. The DASH (Dietary Approaches to Stop Hypertension) eating plan is proven to lower BP.
• Reduce sodium intake: Aim for less than 2,300 mg per day (ideally 1,500 mg if you have high BP).
• Stay active: At least 150 minutes of moderate exercise weekly, such as brisk walking or swimming.
• Limit alcohol: No more than one drink per day for women, two for men.
• Manage stress: Practice deep breathing, meditation, or gentle yoga—chronic stress can contribute to elevated readings.

Tracking your blood pressure trends can help you and your doctor make better decisions. Consider keeping a daily log or using a monitoring tool to stay informed.

When to Talk to Your Doctor

Seek medical advice if:

• Your home readings are consistently above 140/90 mm Hg
• You notice symptoms like frequent headaches, dizziness, or shortness of breath (though these are late signs)
• You start a new medication and observe a change in your BP
• You’re unsure whether a supplement or OTC product is safe with your current regimen

Never ignore unexplained spikes in blood pressure—they may point to a treatable cause, including medication side effects.

Stay Informed, Stay Healthy

High blood pressure is manageable, especially when caught early. Being aware of medications that raise blood pressure is an important step in protecting your long-term heart health. Small adjustments—like switching from an NSAID to a safer pain reliever or choosing a decongestant-free allergy medicine—can make a meaningful difference. If you're unsure, talking to your doctor is always a good idea. Together, you can balance treating your symptoms while keeping your cardiovascular system strong and stable.

FAQ

#### Can over-the-counter pain relievers raise blood pressure?

Yes, certain over-the-counter pain relievers—especially NSAIDs like ibuprofen and naproxen—can increase blood pressure by causing fluid retention and reducing kidney function. Acetaminophen is generally a safer option for people with hypertension, but always check with your doctor first.

#### What medications commonly cause high blood pressure?

Common medications that raise blood pressure include NSAIDs, decongestants (like pseudoephedrine), corticosteroids (e.g., prednisone), some antidepressants (especially TCAs and MAOIs), and hormonal therapies containing estrogen. Some immunosuppressants and stimulant-based weight-loss drugs also carry risks.

#### Can allergy medicines affect my blood pressure?

Yes, many over-the-counter allergy medicines contain decongestants such as pseudoephedrine or phenylephrine, which can elevate blood pressure by constricting blood vessels. Antihistamines without decongestants (like loratadine or fexofenadine) are usually safe alternatives.

#### How quickly can a medication raise blood pressure?

Some medications can affect blood pressure within hours (e.g., decongestants), while others may cause gradual increases over days or weeks (e.g., steroids or NSAIDs used long-term). Regular monitoring helps catch changes early.

#### Should I stop taking a medication if I think it's raising my blood pressure?

No—do not stop any prescribed medication without consulting your doctor. Instead, record your blood pressure readings and discuss your concerns during your next appointment or sooner if readings are high. Your provider can recommend safer alternatives if needed.