Medication Causes of Hypertension

Aka: Medication Causes of Hypertension, Hypertension due to Medications, Hypertension due to Herbals, Herbal Causes of Hypertension, Toxin Induced Hypertension, Elevated Blood Pressure due to Medications, Hypertension due to Chemotherapy, Drug Induced Hypertension

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II. Causes: Medication Related Syndromes

  1. Antihypertensive Withdrawal
  2. Alcohol Withdrawal
  3. Serotonin Syndrome
  4. Anticholinergic Syndrome
  5. Malignant Hyperthermia

III. Causes: Sodium retaining agents

  1. Oral Contraceptives (occurs in 5% of users)
    1. Hypertension is typically with Estrogen doses of 50 mcg or more
    2. Hypertension more likely if history of PIH, Tobacco use, black race, Obesity, renal disease, Diabetes Mellitus
  2. Estrogen Replacement Therapy
  3. Licorice (>3 g/day, found in chewing Tobacco)
  4. Excessive Dietary Sodium (>2.4 g/day)
  5. High Sodium Antacids
  6. Mineralocorticoids
  7. Glucocorticoids or Corticosteroids (e.g. Methylprednisolone, Prednisone)
  8. Anabolic Steroidsand androgens

IV. Causes: Miscellaneous agents

  1. Antiinflammatory agents
    1. Nonsteroidal antiinflammatory Drugs (NSAIDs)
    2. Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors such as Celebrex)
  2. Levothyroxine (excessive dosing, iatrogenic Hyperthyroidism)
  3. Erythropoietin
  4. Growth Hormone
  5. Ketoconazole
  6. Alcohol Abuse (>21 oz/week, >300 grams/week)

V. Causes: Chemotherapeutic and Immunosuppressive Agents

  1. Vascular Endothelial Growth Factor inhibitors
  2. Cyclosporine (significantly raises Blood Pressure)
  3. Sirolimus
  4. Tacrolimus
  5. Alkylating Agents
  6. Bevacizumab (Avastin)
  7. Cis-diamminedichloroplatinum (intraarterial)
  8. Paclitazel
  9. Sorafenib (Nexavar)
  10. Sunitinib (Sutent)

VI. Causes: Neurologic and psychiatric agents

  1. Serotonin-Norepinephrine reuptake inhibitors
    1. Venlafaxine (Effexor)
    2. Duloxetine (Cymbalta)
  2. Fluoxetine (Prozac)
  3. Bupropion (Wellbutrin)
  4. Tricyclic Antidepressants
  5. Monoamine Oxidase Inhibitors (MAO Inhibitors)
  6. Lithium
  7. Clozapine (Clozaril)
  8. Carbamazepine (Tegretol)

VII. Causes: Stimulants (Sympathomimetics)

  1. Ergonomic aids (e.g. Anabolic Steroids)
  2. Cocaine
  3. Phencyclidine (PCP)
  4. Amphetamine or Methamphetamine
  5. Caffeine
  6. Dietary supplements (e.g. Ephedra)
  7. Appetite Suppressants (e.g. Sibutramine)
  8. Decongestants (e.g. Pseudoephedrine, Afrin)

VIII. Causes: Herbals

  1. Aniseed
  2. St. Johns Wort
  3. Capsicum
  4. Cola alkaloids
  5. Blue Cohosh
  6. Vervain
  7. Agnus cactus
  8. Calamus amines
  9. Broom alkaloids
  10. Bayberry
  11. Licorice
  12. Gensung
  13. Ginseng
  14. Guarana
  15. Ma Huang (Ephedra)
  16. Pau de Arco
  17. Coltsfoot
  18. Gentian
  19. Ginger

IX. References

  1. Charles (2017) Am Fam Physician 96(7): 453-61 [PubMed]
  2. Grossman (2015) Eur J Pharmacol 763(pt A):15-22 [PubMed]

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