A person with high blood pressure, heart disease, or other heart issues should take care when selecting cold and flu medication. Certain medications, particularly ones with decongestants in them, can raise a person’s blood pressure.
Keep reading for more information on cold medications for people with high blood pressure, including safety concerns, and alternative treatment options.
Share on PinterestA person with hypertension or heart disease should talk to their doctor about the most suitable cold medication.
Some cold and flu medications can elevate a person’s blood pressure. For most people, this is not a major cause for concern. They are unlikely to experience any harm if they take the medications for a short duration while sick.
However, people with high blood pressure, or hypertension, should be cautious when selecting cold medications. Certain cold medications can cause blood pressure to rise to a dangerously high level. Some can interfere with the effectiveness of drugs people are taking to treat hypertension or heart disease.
Some drugs that can be problematic for people with hypertension or heart disease include:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that help alleviate inflammation and pain. The NSAIDs ibuprofen (Advil) and aspirin are popular choices for easing the symptoms of a common cold.
According to a 2014 review, ibuprofen increases the risk of hypertension and stroke, whereas aspirin does not increase these risks.
A 2017 study investigated whether taking NSAIDs to treat an acute respiratory infection (ARI) increases the risk of a heart attack. The study included 9,793 people who had previously been in the hospital for a heart attack. The average age of the participants was 72 years.
The study found that people with hypertension who took NSAIDs for an ARI were around three times more likely to have a heart attack. However, the authors noted that merely being sick can raise a person’s blood pressure and increase their risk of having a heart attack.
Overall, the findings suggest that a person who has hypertension or heart disease should avoid using NSAIDs to treat cold symptoms. People should talk to their doctor about other pain medications that may be safer.
Decongestants are drugs that help to alleviate the symptoms of a blocked nose. However, these drugs can pose a risk to a person with hypertension, heart disease, or other cardiovascular disorders.
Decongestants work by constricting blood vessels in the sinuses. However, they also constrict blood vessels elsewhere in the body. This results in increased blood pressure and an elevated heart rate. Decongestants may also interact with blood pressure medications, causing them to be less effective.
Decongestants are available over-the-counter at pharmacies. They are available to buy on their own or as an ingredient in multi-symptom cold and flu medications. People who buy medicines to target multiple symptoms should, therefore, read medication labels carefully.
There are several different types of decongestants. The following types are the most likely to cause issues in people with hypertension:
- ephedrine
- naphazoline
- pseudoephedrine
- oxymetazoline
- phenylephrine
When it comes to alleviating cold and flu symptoms, there are several alternatives to NSAIDs.
There are some cold and flu medications designed for people with hypertension. A person can ask their doctor or pharmacist for more information about these medications.
The following tips may also help to alleviate cold symptoms and assist recovery from a cold:
- drinking plenty of fluids
- drinking warm water or tea with lemon and honey to help soothe the throat
- using a saltwater gargle
- using a saline nasal spray
- using a humidifier to increase indoor humidity
- getting more rest
- using aspirin or acetaminophen to alleviate pain
When at the pharmacy, a person should look for medications that do not contain decongestants or NSAIDs other than aspirin. A person should read the product label carefully and look at the active ingredients list. This is where drug manufacturers typically list the drugs and their effects.
A person should also avoid medications that are high in sodium. These ingredients can also increase a person’s blood pressure.
Some medications, such as NSAIDs, have warning labels on the packaging. The warning is about how the medication may increase a person’s blood pressure. People with hypertension or heart disease should avoid any medications that have this label.
Finally, if a person is not sure, they can ask the pharmacist or their doctor. They should mention any conditions they have, such as hypertension or heart disease, as well as any medications they are taking. The pharmacist or doctor will then outline which medications are safe for the person to take.
A person with hypertension or heart disease should take care when choosing medications to alleviate cold symptoms. They should avoid decongestants and most NSAIDs, as well as medications that contain these ingredients.
People can talk to their doctor or pharmacist for advice on which cold medications are safe for them to take. Home treatments may also help to alleviate cold symptoms and aid recovery.
With the cold and flu season upon us, many of us will come down with some sort of respiratory infection in the coming months and may reach for over-the-counter medicines to treat the symptoms of cold or flu. But did you know that the medicine you take to relieve symptoms could put your heart at risk?
Respiratory infections add stress your heart due to inflammation and taking over-the-counter medicines could further impact your cardiovascular system. While the risks of taking cold and flu medications are minimal for people without heart disease, they can be harmful to those with heart disease. Two of the most commonly used types of OTC medicines can have a negative affect for those with heart disease.
Decongestants such as phenylephrine and pseudoephedrine are one medication of concern for those with heart disease. They work by constricting blood vessels and making them narrower. While that’s helpful in clearing nasal congestion, it can also increase blood pressure, raise heart rate, and make your heart work harder. This can be particularly concerning for those who are sensitive to changes in blood pressure, such as patients with uncontrolled hypertension, heart failure, or increased risk of stroke.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve the aches and pains associated with colds and the flu. For those with healthy hearts, short-term use of NSAIDs are well tolerated. However, research shows they are not always safe for those with heart disease and can increase the risk of heart attack. This type of medications works to increase the amount of sodium in the body, which raises blood pressure and increases fluid retention. The choice of NSAID, duration of use, and dosage all affect the impact to the body, so consulting with a doctor is important if you have existing heart disease or fall into a high-risk category.
Which medications are important to avoid?
For heart patients, decongestants are generally best avoided altogether, especially for those with uncontrolled high blood pressure, heart failure, or a history of heart attack or stroke. Rather than reaching for a decongestant, use an antihistamine or nasal saline sprays or rinses. If a decongestant must be used, use the lowest dose for the shortage duration possible.
NSAIDs taken for a short amount of time are often tolerated, but the choice of NSAID could be important. Talk to your doctor about which option is the safest for you, particularly if you are on blood thinners or other medications for heart disease or if you have been diagnosed with heart failure, heart attack, or stroke.
As always, rest and fluids are a wonderful treatment for mild to moderate colds and the flu. Help prevent seasonal illness by getting your annual flu shot, washing your hands regularly, and avoiding those who are sick. If you do come down with a respiratory infection, contact your doctor at the Oklahoma Heart Hospital for recommendations of the safest medicines to treat your symptoms.
Adverse Effects of Pseudoephedrine: Stroke, Blood Pressure, Heart Rate
A 2003 paper from Mexico identified 22 cases of stroke (out of 2500 stroke cases at their center) that were associated with taking agents like pseudoephedrine within 24 hours. The majority were with phenylpropanolamine but there were 4 cases associated with pseudoephedrine. Given how often pseudoephedrine is taken and how few strokes were reported, it is difficult to draw any conclusions that pseudoephedrine causes stroke
In 2005, a review of all studies looking at oral pseudoephedrine concluded
This analysis demonstrates that pseudoephedrine causes a small but significant mean (1–mm Hg) increase in SBP, with no significant effect on DBP and a slight increase in HR (3 beats/min)
On average, these are very minor changes in blood pressure and heart rate and would be unlikely to cause any problems in the vast majority of patients with significant heart disease or hypertension.
The study found NO increased rate of adverse effects (such as heart attacks or strokes) in the patients taking pseudoephedrine.
Coridicin Hbp, A Typical Mixture Of OTC Ingredients
One of my patients pulled from her purse an OTC cold remedy that appeared to have the American Heart Association seal of approval.
Let us look closely at the benefits and side effects of this typical and common OTC cold/sinus/flu remedy
Typical “Multi-symptom” OTC Cold/Flu/Sinus/Cough Ingredients
-Acetaminophen (tylenol)- helps with aches, pain, headache and fever.
-Dextromethorphan (look for DXM or DM) is commonly found in these kinds of multi-ingredient brand name products and is promoted as reducing cough (as an antitussive). However, there is very little evidence to support its efficacy. This study found 30 mg dextromethorphan no better than placebo at reducing cough. The Cochran Database Review in 2012 concluded :
There is no good evidence for or against the effectiveness of OTC medicines in acute cough.
In addition to lacking evidence for efficacy, dextromethorphan is used as a recreational drug due to its side effect as a dissociative hallucinogen in very high doses. Per Wikipedia:
It may produce distortions of the visual field – feelings of dissociation, distorted bodily perception, and excitement, as well as a loss of sense of time. Some users report stimulant-like euphoria, particularly in response to music
-Chlorpheniramine is an antihistamine. It’s one of the oldest antihistamines and as such is “sedating”. This means it almost certainly is going to make you drowsy. I remember trying to function on medical wards 30 years ago when it was the only antihistamine available and it turned me into a zombie for 24 hours. . Since newer non-sedating antihistamines (like loratadine which is available OTC and generic) have become available I cannot fathom how something like Coricidin has survived.
What is the antihistamine in this hodgepodge of drugs doing for your cold symptoms? Nothing, other than making you drowsy. Antihistamines are useful for allergically related runny nose or sneezing.
What Are the Downsides of Multiple Medication Cold Remedies
I think you are much better off avoiding these brand name mixtures of different active ingredients. Instead, you should take what you need for a specific symptom in the appropriate dosage and time interval. Thus, if you have pain, take the minimal dose of tylenol that relieves it and repeat when it comes back. If you have a cough, recognize that the OTC ingredients are no better than placebo and are being abused as recreational drugs. Most coughs go away shortly but if one is particularly troublesome and persistent get a cough suppressing drug from your physician. If you have a really runny nose with a lot of sneezing it is probably OK to take pseudoephedrine even if you are a heart patient or have high blood pressure. Take it as I described above. Start with 30 mg of the little red Sudafed pills , wait an hour to see how you feel. Take a second if it has not been effective. Repeat at 4-6 hour intervals as needed. Take your blood pressure at least once after starting it. Don’t buy the multi-symptom multiple ingredient combinations which are simply a marketing tool to get you to spend more money on something from which you won’t benefit.