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High Blood Pressure, Decongestants a Bad Mix

Medicines could increase risk of stroke, heart attack

WEDNESDAY, Jan. 16, 2002 (HealthDayNews) -- Having a stuffy nose can be unpleasant, but doctors say that discomfort is minor compared to the risk of taking over-the-counter decongestants if you have high blood pressure.

Though they are generally safe, many popular cold and flu medicines contain decongestants such as pseudoephedrine and phenylephrine, which doctors say may exacerbate blood pressure problems.

And while products containing such ingredients are required to list such warnings on their labels, the warnings often go unnoticed or ignored by many who assume over-the-counter drugs are safe for one and all.

"The warnings are very often ignored," says Dr. Lynn Smaha, past president of the American Heart Association. "But people who have a history of heart trouble or high blood pressure should be very careful in adhering to the warnings on the labels of these drugs."

One big reason such warnings may be ignored is because nearly half of the estimated 50 million people in the United States with high blood pressure don't even realize they have a problem, says Smaha.

Those who are aware of their condition may still take the warnings lightly because people don't associate something as benign as a stuffy nose with high blood pressure. However, Smaha says, the two conditions have at their core a very important common denominator -- blood vessels.

Because stuffy noses lead to swollen nasal blood vessels, a goal of decongestants is to shrink those blood vessels to allow better airflow and nasal drainage.

The problem, however, is that the active ingredients in many decongestants can't target the blood vessels in the nose. Instead, they constrict blood vessels throughout your body, and raise your blood pressure. If you already have high blood pressure, that can increase your risk for stroke or heart attack, experts say.

"The drugs in decongestants are actually some of the same things used in surgery to increase the blood pressure if a patient's blood pressure gets too low, and they're used in labs to raise the blood pressure in laboratory animals," explains Smaha. "So you really don't want to use them if your blood pressure is high."

Furthermore, Smaha says, the decongestants can work against anti-hypertensive drugs that patients might take for their high blood pressure.

There are over-the-counter cold and flu products that claim to be safe for people with high blood pressure, but according to Charles Ruchalski, an assistant professor at Temple University's School of Pharmacy, they're unlikely to help those looking for a decongestant.

"Products that say they're safe for people with high blood pressure are probably safe precisely because they don't have decongestants. They may have an expectorant, which is safe, and maybe an antihistamine, which also doesn't raise blood pressure, but they're likely not going to help with a stuffed-up nose," he says.

So, what's a person with a stuffed snout and high blood pressure to do? Experts say you can consult your doctor to see if a prescription medication may be warranted, but in most cases, grandma's advice is probably still the best.

"When you've got a congested nose, it's usually just a temporary symptom you're dealing with, so if you can tolerate that for the two or three days that it's going to last, it's probably best to simply have some chicken soup, drink lots of fluids and get lots of rest," says Ruchalski.

What To Do

Read more about how to manage high blood pressure at the American Heart Association.

In addition, here's some useful information on the common cold from the National Institute of Allergy and Infectious Diseases.

SOURCES: Interviews with Lynn Smaha, M.D., senior vice president, academic affairs, and past president, American Heart Association, Dallas; Charles Ruchalski, Pharm. D., assistant professor, Temple University School of Pharmacy, Philadelphia
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