Over-the-counter drugs that can boost blood pressure

As winter arrives and the cold and flu season starts to peak, many people head to pharmacies looking for products to ease their sniffles and aches. Remedies for cold, allergy, and sinus problems are the most frequently purchased category of over-the-counter drugs in this country. Pain relievers such as ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are also very popular — and frequently found in combination cold and flu medicines. But some of these products may be risky for people with high blood pressure. Here’s some guidance about what to avoid and suggestions for safer alternatives.

Clearing a stuffy nose

“The most concerning products are those that contain decongestants, because they constrict or narrow blood vessels, which can raise blood pressure,” says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital. When you have a cold, your body sends extra blood to your nose. The blood vessels and nearby tissues swell, causing congestion or a stuffy nose. But if you take a decongestant, it affects all your blood vessels, not just those in your nose. That’s why it’s safest to avoid products that contain oxymetazoline (Afrin), pseudoephedrine (Sudafed), and phenylephrine (Suphedrin PE).

However, you can’t simply avoid those brand names, as many dozens of other products include those decongestants in their ingredient lists, says Doyle Petrongolo. Many are combination products that contain one or more additional drugs to treat a fever, cough, or sore throat, for example. When you include generic and store brands (which differ among pharmacy chains), there are an overwhelming number of choices. Rather than scrutinizing every label, she advises people to ask a pharmacist to recommend a product that contains no decongestants and is safe for people with high blood pressure.

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Some people find that antihistamines — which relieve symptoms such as a runny nose, watery eyes, and sneezing — can ease some cold and flu symptoms. Examples include chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl). While they don’t affect blood pressure, older people should be very cautious when taking these medications, since they can cause drowsiness and blurry vision, which increases the risk of falls, says Doyle Petrongolo.

Relieving aches and pains

People with high blood pressure should also try to minimize their use of NSAIDs, which include ibuprofen (Advil, Motrin) and naproxen sodium (Aleve, Naprosyn). These drugs, which are metabolized by the kidneys, encourage the body to hold on to salt and water. The resulting extra fluid in the body can raise blood pressure. NSAIDs can also damage blood vessels, causing cardiovascular problems (see “An often-overlooked label warning”).

Taking NSAIDs for the occasional headache or strained muscle isn’t typically a problem. But some people with aches and pains take them on a routine basis, sometimes more out of habit more than necessity. “If you have pain that’s bad enough that you feel the need to take ibuprofen for more than a few days, see your doctor,” says Doyle Petrongolo. He or she can assess whether you need a prescription-strength pain reliever, she adds, noting that uncontrolled pain can also boost blood pressure.

Acetaminophen (Tylenol) may be a good alternative, although it doesn’t have the inflammation-quelling properties of NSAIDs. For people with joint pain from arthritis, another option is diclofenac topical gel (Voltaren Arthritis Pain). Available by prescription in pill form, diclofenac is an NSAID. But the over-the-counter gel formulation is thought to be safer than taking a pill because lower levels of the drug end up in the bloodstream.

An often-overlooked label warningMost people don’t realize that labels of over-the-counter NSAIDs include this caution: “Heart attack and stroke warning: NSAIDs, except aspirin, increase the risk of heart attack, heart failure, and stroke. These can be fatal. The risk is higher if you use more than directed or for longer than directed.”

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Owe no one anything, except to love each other, for the one who loves another has fulfilled the law. Romans 13:8

Set me as a seal upon your heart, as a seal upon your arm, for love is strong as death, jealousy is fierce as the grave. Its flashes are flashes of fire, the very flame of the LORD. Many waters cannot quench love, neither can floods drown it. If a man offered for love all the wealth of his house, he would be utterly despised. Song of Solomon 8:6-7

There are three things that amaze me—no, four things that I don’t understand: how an eagle glides through the sky, how a snake slithers on a rock, how a ship navigates the ocean, how a man loves a woman. Proverbs 30:18-19

Who can find a virtuous woman? For her price is far above rubies. Proverbs 31:10

Two are better than one, because they have a good return for their labor: If either of them falls down, one can help the other up. But pity anyone who falls and has no one to help them up. Also, if two lie down together, they will keep warm. But how can one keep warm alone? Ecclesiastes 4:9

Be kind to each other, tenderhearted, forgiving one another, just as God through Christ has forgiven you. Ephesians 4:32
I am my beloved’s, and my beloved is mine. Song of Solomon 2:16

Many waters cannot quench love; rivers cannot wash it away. Song of Solomon 8:7

I have found the one whom my soul loves. Song of Solomon 3:4

This is my commandment, that you love one another as I have loved you. John 15:12

God has poured out his love into our hearts. Romans 5:5

Love yesterday, today and forever. Jeremiah 31:3

So they are no longer two, but one. Therefore what God has joined together, let man not separate. Matthew 19:6

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