Are Cold Remedies Enough to Raise Blood Pressure?

You have a stuffy head, scratchy throat, and feel achy and feverish. Time to head out to the local drugstore, you think, and stock up on all those cold and flu remedies that promise relief from what's knocking you sideways.

But before you get in the car, tissue in hand, you might want to think about taking your blood pressure.

Over-the-counter cold and flu medications, particularly those chock-full of decongestants, can make your blood pressure soar, doctors warn. And for anyone with high blood pressure, the seemingly innocuous cold remedy can turn out to be quite dangerous.

"You can take these medications and the result could be the kind of symptoms triggered by an increase in blood pressure such as heart rhythm abnormalities or arrhythmias, coronary events, or even a stroke," says Fernando Costa, M.D., a staff scientist with the American Heart Association (AHA) in Dallas, Tex.

"And while a lot of people with high blood pressure take these kinds of medications and have no problems, those who have uncontrolled high blood pressure, those who are not taking blood pressure medication or those who have blood pressures of 160 over 90 could be in trouble," Costa adds.

Blood pressures of 140 over 90 are considered high. When your heart beats, it pushes blood through the arteries, creating pressure. If you're arteries are elastic, no problem. But more rigid arteries result in higher blood pressure. The first number in a blood pressure reading, called the systolic pressure, represents the pressure while the heart is beating. The second number, the diastolic, represents the pressure when the heart is resting between beats.

Blame adrenergic compounds such as pseudoephedrine, phenylephrine and phenylpropanolamine (also known as PPA), for the blood pressure problem, Costa says. Adrenergics, found in over-the-counter nasal decongestants and cough and cold products, help to relieve a stuffy nose by constricting blood vessels, thereby reducing the swelling in nasal passages. They also relieve the minor aches and pains of the flu, Costa says. But taking oral decongestants also may cause blood pressure to go up as they constrict blood vessels.

Phenylpropanolamine may be especially dangerous, says the U.S. Food and Drug Administration. The federal agency asked companies that market prescription or over-the-counter medicines containing phenylpropanolamine to voluntarily discontinue them. A Yale study showed that the compound puts people, particularly women, at an increased risk for hemorrhagic stroke (bleeding in the brain).

High blood pressure can occur in adults or children, but the condition is much more common in people older than 35. African-Americans, middle-aged and elderly people, those who are obese, who drink heavily and women who are taking birth control pills are much more prone to hypertension. More than 50 million (one in four) Americans suffer from the condition, according to the AHA.

High blood pressure is often known as the "silent killer" because many people can have it for years and not know it. The only way you know you have high blood pressure is to have it checked.

If you already know you have high blood pressure, what should you do when you catch a cold or the flu?

Besides the normal mantra of plenty of bed rest and lots of fluids, try medications with acetaminophen and chlorpheniramine and/or dextromethorphan, Costa says.

Also, the AHA says there is a new generation of cold, cough and flu medications designed just for people with high blood pressure. The AHA says, "Coricidin HBP products are specially formulated for people who have high blood pressure. They provide safe and effective cough, cold and flu relief, and they're decongestant-free, so they won't raise your blood pressure."

Schering-Plough HealthCare Products, the maker of Coricidin HBP products, is sponsoring the AHA's high blood pressure Web site.

Perhaps even more important than avoiding medications with decongestants is getting blood pressure under control in the first place.

Here's what you can do:

• Keep tabs on you blood pressure; have it checked regularly.

• Lose weight. People with a body mass index of 30 or more are much more likely to develop hypertension.

• Reduce the amount of salt in your diet, and eat more fruits and vegetables.

• Eat a low-fat diet.

• Don't smoke.

• Get plenty of exercise.

And don't forget to read the small print on the box of any over-the-counter medication at the drugstore.

Related Articles Risk Factors for Hypertension Going the Extra Mile

External Sources American Heart Association U.S. Food and Drug Administration Journal of the National Cancer Institute, Dec. 19, 2001 issue

This article was reviewed and updated June 2007.

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