Drug-Induced Hypertension

Drug-induced hypertension is often underestimated. Several drugs prescribed for conditions other than hypertension as well as some herbal remedies, over-the-counter drugs, or recreational drug use (cocaine, anabolic steroids, etc.) can increase blood pressure or blunt the blood pressure-lowering effect of antihypertensive treatments. Some drugs induce sodium retention associated with extracellular volume expansion. Others directly or indirectly activate the sympathetic nervous system, act directly on arterial smooth muscle tone, or have no clear mechanism of action. Other drugs may directly or indirectly interfere with the pharmacokinetic and/or pharmacodynamic profile of the antihypertensive drugs and thus can reverse their blood pressure-lowering effect. Careful evaluation of the drugs taken by patients for conditions other than cardiovascular diseases, through the completion of a standardized questionnaire or the use of drug–drug interaction-checking websites, can help to identify drug-related hypertension.