Side Effects of Blood Pressure Meds
Life-saving antihypertensive drugs are widely used to lower blood pressure linked with damage to the brain, eyes, heart, arteries and bodily organs. They also prevent injury or death from stroke or heart attack. However, antihypertensive medications can cause mental and physical side effects, some of which may seriously affect vulnerable individuals, especially older adults.
“Older adults are more susceptible to side effects such as mental confusion or dizziness that can lead to falls, abnormal heart rhythms, electrolyte abnormalities, weakness, and many other undesirable symptoms,” says Jonathan Alpert, MD, PhD, Director of the Depression Clinical and Research Program at MGH. “That’s why it’s important that people with high blood pressure work closely with their doctors to find the right balance in controlling hypertension, incorporating factors such as diet, weight management, medication, and exercise to facilitate blood pressure control.”
Drug Side Effects
Common antihypertensive drugs and their side effects include:
Diuretics: These drugs help combat fluid retention associated with high blood pressure and renal disease by prompting the kidneys to rid the body of excess salt and water. They are often combined with other antihypertensive medications. Diuretics can help prevent heart failure; however, some types of diuretic combinations may boost blood sugar levels and contribute to increased risk for diabetes. Others may deplete the body’s supply of potassium. Potassium depletion over time is associated with greater risk for irregular heartbeat and, very rarely, heart attack. Other side effects associated with diuretics may include low blood pressure, resulting in feelings of dizziness when rising quickly from a prone or seated position, frequent urination, fatigue, dehydration, weakness, depression and irritability, reduced sexual function in men, muscle cramps, elevated levels of uric acid that increase risk for gout, and a low ratio of electrolytes to water that can interfere with cell formation in the body and brain. Because diuretics are frequently combined with other drugs, care must be taken to ensure that the patient is not taking too much of this medication overall.
WHAT YOU CAN DO
You may be able to cope with less serious side effects of antihypertensive medications on your own by using the strategies listed below. Consult with your doctor if symptoms continue or worsen.
- Dizziness: When rising from a prone position, sit up slowly and spend some time seated with your feet dangling toward the floor. Always stand up slowly from a seated position. This will help prevent a sudden drop in blood pressure that can lead to lightheadedness or even fainting.
- Dehydration: Drink plenty of fluids through the day. Tackle dry mouth by melt-ing ice in your mouth, or sucking on sugar-free candies and chewing sugarless gum.
- Increased sensitivity to cold and/or sunlight: Choose warm clothing, and cover your extremities in cold weather. Try to minimize direct exposure to strong sunlight from 10 a.m. to 3 p.m.
- Frequent nighttime urination: Taking your medication in the morning may help you avoid an overactive bladder at night. Check with your doctor.
- Constipation: Exercise regularly and eat foods with plenty of fiber, such as whole grains, fruits and vegetables.
- Drowsiness: Taking a blood pressure medication closer to bedtime may mini-mize this side effect. Check with your doctor.
- Potassium loss: Consume plenty of potassium-rich foods, such as fruits and vegetables.
- Stomach upset: Find out from your doctor whether you can take your medication with a meal, or with a glass of milk.
ACE inhibitors: Angiotensin converting enzyme (ACE) inhibitors widen blood vessels and reduce the workload of the heart in driving blood through the blood vessels. Side effects may include low blood pressure accompanied by feelings of dizziness and lightheadedness, an irritating dry cough, and increased potassium levels. Some patients may also experience skin rash or lack of taste.
ARBs: Angiotensin II receptor blockers (ARBs): ARBs lower blood pressure by shielding blood vessels from a hormone that causes them to narrow, thereby opening them and easing the workload of the heart. Common side effects include raised potassium levels, low blood pressure, dizziness and lightheadedness, drowsiness, or nasal congestion.
Beta blockers: Beta blockers reduce blood pressure by helping to slow the heartbeat. Rapid withdrawal from the drug may have a rebound effect that causes faster heartbeat and higher blood pressure, increasing risk for angina or heart attack. These medications can cause lightheadedness, dizziness, weakness, fatigue, depression, memory loss, nightmares, coldness in the extremities, and reduced sexual drive, as well as a rapid drop in blood pressure when rising from a prone or seated position. When combined with a diuretic, they may also increase risk for diabetes.
Calcium channel blockers: This medication lowers blood pressure by helping to relax blood vessels. Side effects may include constipation, swelling in the feet, fatigue, rash, rapid or irregular heartbeat, headache, erectile dysfunction, and dizziness.
Renin inhibitors: A relatively new type of medication, renin inhibitors decrease chemicals that cause blood vessels to narrow. Side effects may include cough, heart-burn, stomach pain, diarrhea, or rash.
Vasodilators: As their name implies, these drugs relax muscles in the walls of blood vessels, causing them to dilate. Side effects may include headaches, irregular or rapid heartbeat, aching of joints, fluid retention, and swelling around the eyes.
Monitoring
Most side effects diminish with time, but if they do not, it’s best to seek the advice of a medical care professional with a thorough understanding of the characteristics of available medications and their effects on patients. The response to a specific drug may be influenced by factors such as a person’s overall health and medical history, physical characteristics, interactions with other drugs that the individual is taking, and other concerns. Monitoring of blood pressure medications may involve tracking blood pressure levels and undergoing occasional blood tests to deter-mine levels of potassium, blood sugar, electrolyte levels, and other blood chemicals that might be influenced by the drugs.
“Consult with your doctor if you experience any symptoms related to your medication that are especially troublesome or persist for a long time, but never stop taking your medication without your doctor’s permission,” Dr. Alpert advises. “Your symptoms can be effectively addressed in various ways, including a change in the dosage or the timing of a medication, the addition of another blood pressure medication, or a switch to another drug altogether. On your own, there are steps you can take that may help ease side effects without necessitating a change in medication (See What You Can Do).”
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