A few days ago, a neighbor in the community, a woman in her 40s, came to me to consult about high blood pressure.
It is said that the blood pressure has been normal before and suddenly increased recently.
Women in their 40s, approaching menopause? Many menopausal women have elevated blood pressure.
Ask the patient, she said that there is really a problem. She has not had her period in the past 3 months. She went to the gynecology doctor and gave her hormones, 14 days for estrogen and 14 days for progesterone. , I have to eat for 3 months in a row, and I have to do an artificial cycle. But just after 1 cycle of eating, blood pressure began to rise, rising to more than 140/90mmHg.
Estrogen, progesterone? Of course it can raise blood pressure! Taking birth control pills can raise blood pressure. The study found that the blood pressure changes of oral combined contraceptives mainly occurred in the first 6 months, but long-term use, the blood pressure always showed an increasing trend, and the occurrence of hypertension increased.
Therefore, high blood pressure caused by estrogen and progesterone is quite common in drug-induced hypertension.
Drug-induced hypertension, a common type of secondary hypertension
To say that high blood pressure is mostly primary, accounting for the majority, and only about 10% secondary, but there are many factors that can cause secondary blood pressure to rise high. Normal people can increase, and hypertensive patients can even increase. Drugs are one of the most important ones. Drug-induced hypertension is a common type of secondary hypertension. Therefore, sometimes if you are not careful, you may inadvertently have factors that increase blood pressure.
Many common medications can raise blood pressure, to name a few.
Licorice, ephedra and their preparations: like licorice and ephedra in traditional Chinese medicine, and licorice mixture, ammonium glycyrrhizate, and ephedrine preparations in western medicine.
Multiple hormones: estrogens, progestins, androgens, glucocorticoids, mineralocorticoids, thyroxine, and more.
Drugs that affect sympathetic nerve stimulation: such as the beta agonists salbutamol and bambuterol used in asthma and bronchitis patients, and theophylline drugs such as Aminophylline, Dihyprophylline (Chuanding), etc.
Anti-depressant and anxiety medications can also raise blood pressure. For example, venlafaxine (Inos), paroxetine (Selote, Leyou, flupentixol and melitracen (Delixin), etc.
New anti-tumor drugs: Like some anti-tumor targeted drugs, they specifically inhibit angiogenesis. The intention is to starve the tumor to death, but the blood vessels are damaged. , blood pressure is high.
Non-steroidal anti-inflammatory drugs: such as indomethacin, ibuprofen, celecoxib (Celebrex), etc.
Erythropoietin. This is often used by patients with renal failure and anemia, and it also has the effect of raising blood pressure. Patients with renal failure themselves have high blood pressure, so be careful when taking medicine.
There is actually another treatment, Intravenous infusion, saline infusion, 0.9% sodium chloride injection. Saline can be expanded. During rescue, the blood pressure is low, and the first is to infuse saline. Like some elderly people who listened to some rumors, in the spring and autumn seasons, they should infuse some medicines for “activating blood circulation and removing blood stasis” to open blood vessels and prevent cerebral infarction.
Drugs can raise blood pressure through different mechanisms, and a single drug can raise blood pressure through multiple pathways. For example, it will cause water and sodium retention, which will increase the volume of blood vessels; or stimulate the sympathetic nerves, increase the tension of blood vessels, and increase the heartbeat; it will also stimulate the renin-angiotensin-aldosterone system, which The system regulates the increase of blood pressure through various mechanisms; it also affects neurotransmitters, which also affects the sympathetic nerves; and also affects vasodilators, damages the kidneys, causes insulin resistance, and so on.
For patients without high blood pressure, find the cause when they find high blood pressure; for patients with high blood pressure, if the blood pressure fluctuates and it is difficult to control, they should also find the cause. find the reason. Some refractory hypertension, that is, some secondary factors have not been removed, so the blood pressure is not easy to control.
Recognizing and attaching importance to drug-induced secondary hypertension also has another significance, which is to prevent the sudden drop in blood pressure when the drug is withdrawn.
For example, after taking some drugs that can increase blood pressure, the blood pressure rises, and the amount of antihypertensive drugs is increased, but I or my family members do not know or understand! One day, these drugs that can raise blood pressure are suddenly stopped, but the antihypertensive drugs are not reduced, and the blood pressure will suddenly drop. In severe cases, people with other pre-existing diseases will be in danger. We rescued an elderly patient with hypertension and coronary heart disease who had been taking the antidepressant venlafaxine and antihypertensive drugs for a long time. Just because he wanted to change the medicine, he suddenly stopped venlafaxine, and his blood pressure suddenly dropped to the level of shock. , followed by acute myocardial infarction.
Drugs that affect blood pressure are commonly used in our daily lives. Pay attention to monitoring blood pressure before and after taking these drugs. Or when blood pressure fluctuates, you should review the medicines you are taking. When you see a doctor, you must inform the doctor of the original disease and the medicines you are taking.
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