How Winter Infections and Blood Pressure Interact—Especially for Adults 50+

If you're over 50 and managing high blood pressure, you may have noticed your readings acting up when you catch a cold or the flu. You're not imagining it—there’s a real, well-documented link between infections and blood pressure. During winter, when respiratory viruses like influenza, RSV, and even common cold coronaviruses circulate more widely, many older adults experience unexpected spikes—or sometimes drops—in their blood pressure. This isn’t just “feeling under the weather”; it can affect how well your hypertension treatment works and increase short-term cardiovascular risk.

A common misconception is that only severe illnesses (like pneumonia) impact BP—yet even mild colds can trigger measurable changes. Another myth? That blood pressure fluctuations during illness are harmless “blips.” In reality, a sudden rise from, say, 130/80 mm Hg to 160/95 mm Hg—even for a few days—can strain the heart and arteries, especially if you’re already living with long-standing hypertension or conditions like diabetes or kidney disease.

Why infections and blood pressure matter in winter

Your body’s response to infection involves several systems that directly influence blood pressure regulation. First, inflammation ramps up—releasing cytokines that can cause blood vessels to constrict and increase arterial pressure. Second, fever raises heart rate and cardiac output, which often pushes systolic BP upward. Third, dehydration (from reduced fluid intake, fever, or sweating) thickens the blood and reduces circulating volume—paradoxically leading to both elevated BP (due to increased vascular resistance) and, in some cases, dangerous drops (especially if you’re on diuretics or ACE inhibitors).

Add in winter-specific factors—less physical activity, drier indoor air irritating airways, disrupted sleep, and seasonal dips in vitamin D—and it’s no surprise that BP control becomes trickier from December through February. Studies show that hospital admissions for hypertensive crises rise by about 20% in colder months, and a 2022 analysis in Hypertension found seniors with recent upper respiratory infections were 1.7 times more likely to experience BP variability beyond their usual range.

How to monitor your blood pressure accurately during illness

Measuring BP while sick requires extra care. Avoid checking right after coughing, using nasal decongestants (like pseudoephedrine), or taking NSAIDs such as ibuprofen—these can all temporarily raise readings. Instead:

• Wait at least 30 minutes after coughing, eating, or using a decongestant
• Sit quietly for 5 minutes before measuring—no scrolling on your phone!
• Use the same arm, same time of day, and a validated upper-arm cuff (wrist cuffs are less reliable, especially in seniors)
• Take two readings, 1–2 minutes apart; record both

Keep in mind: A single high reading isn’t cause for alarm—but three consecutive readings above 140/90 mm Hg while symptomatic warrant a call to your provider. Also watch for “masked” low BP: dizziness on standing, fatigue, or confusion could signal hypotension, particularly if you’re on multiple antihypertensives.

Who should pay special attention this season?

Seniors aged 65+—especially those with existing heart disease, chronic kidney disease, or diabetes—are most vulnerable to BP instability during infections. So are people taking certain medications: beta-blockers (which blunt heart rate responses), alpha-agonists (like clonidine), or combination regimens involving diuretics and RAAS inhibitors (ACE inhibitors or ARBs). If you’ve had a recent hospitalization for heart failure or a stroke, even a mild cold deserves closer BP tracking.

Also worth noting: People with white-coat hypertension or masked hypertension may see their “true” patterns emerge during illness—making this an unintentional but valuable window into how your system responds under stress.

Practical steps to support stable blood pressure this winter

Start with hydration—aim for 6–8 glasses of water daily, even if you’re not feeling thirsty. Warm herbal teas (without caffeine or licorice) count too. Prioritize rest: Your body uses significant energy fighting infection, and sleep supports healthy autonomic nervous system balance—key for steady BP.

Continue taking prescribed BP meds unless your doctor advises otherwise. Don’t stop ACE inhibitors or ARBs just because you have a cold—current guidelines strongly recommend continuing them, even with mild illness (though they should be paused if you develop significant dehydration or kidney function changes).

Eat light, potassium-rich foods (bananas, steamed spinach, baked sweet potatoes) to support vascular tone—but skip high-sodium soups or broths unless advised by your clinician. And skip over-the-counter cold remedies with pseudoephedrine or phenylephrine—they’re known to raise BP by 5–15 mm Hg systolic.

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. Call your healthcare provider if you notice:

• Systolic BP consistently >160 mm Hg or <100 mm Hg
• Diastolic BP >100 mm Hg or <60 mm Hg
• Dizziness, chest tightness, shortness of breath, or blurred vision with BP changes

These aren’t just “winter blues”—they’re signals your body needs extra support.

In short, infections and blood pressure are closely linked—especially when you're over 50 and navigating colder months. But with awareness and small, consistent actions, you can protect your cardiovascular health without adding stress to your season. If you're unsure, talking to your doctor is always a good idea.

FAQ

#### Can a cold or flu raise blood pressure in older adults?

Yes—viral infections trigger inflammation, increased heart rate, and fluid shifts that commonly elevate systolic BP by 10–25 mm Hg. This effect is more pronounced in adults over 60, especially those with pre-existing hypertension.

#### How do infections and blood pressure interact in seniors with heart disease?

Infections and blood pressure instability can worsen cardiac workload and oxygen demand, increasing risk for arrhythmias or acute decompensated heart failure. Seniors with coronary artery disease or prior heart attacks should monitor BP closely—and avoid NSAIDs or decongestants without medical guidance.

#### Do respiratory infections cause low blood pressure too?

Occasionally—yes. Severe dehydration, sepsis (rare with colds but possible with flu or pneumonia), or medication interactions (e.g., diuretics + vomiting) can lead to hypotension. Symptoms like lightheadedness when standing or mental fogginess deserve prompt evaluation.

#### Should I stop my blood pressure meds if I get the flu?

Generally, no. Most antihypertensives—including ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers—should be continued unless your doctor advises otherwise. Stopping them abruptly can cause rebound hypertension.

#### Is there a link between RSV and blood pressure changes in older adults?

Emerging evidence suggests yes—RSV (respiratory syncytial virus), once thought to mainly affect infants, causes significant respiratory illness in seniors and is associated with increased BP variability and higher rates of cardiovascular events in the week following infection.