Q: A recent national survey by Bruskin Research Omnitel indicates that people with high blood pressure and their family members are unaware that over-the-counter flu and cold medications can be harmful to hypertension patients. What is the loudest message this sent to cardiologists?
A: That more patient education is going to be necessary. (Researchers) did this survey about cold and flu medications, but even herbals and vitamin supplements can have side effects for the patient. ... They sometimes take things and don't realize they're a medication. You can end up with a combination (of medications) that you shouldn't be on.
Q: What is in cold and flu medicines that pose a danger?
A: Particularly the decongestants. They're an alpha block that causes constriction of the blood vessels in the nose, but they also constrict the blood vessels in other parts of the body. There are some patients where it can tremendously raise their blood pressure from one or two doses. Other patients, it may not raise it at all, even when they take quite a bit.
Q: Are there several decongestant products that are troublesome or what should people look for on a label?
A: Basically, they want to have a medication for a cold that does not include a decongestant. For a cough, you can buy a cough syrup that just has a cough suppressant. Cold medications with expectorants are OK. It's not always marked clearly; you have to read the label. If it says 'decongestant,' it should raise a red flag.
Q: You've told us that decongestants constrict blood vessels and can raise blood pressure in hypertensive patients, but does it have similar adverse affects on those without high blood pressure?
A: It can. I've had some patients who came to see me because their blood pressure was high and they also chronically took cold medications. After they get off, their blood pressure returns to normal. It just depends on the patient. It's not just decongestants. Some of the arthritis medications ... can cause fluid retention and that raises the blood pressure. Advil and Aleve should be avoided (by hypertension patients) unless a doctor approves it. Some of the medications also (block or hinder) what some of the prescribed medication should be doing.
Q: What other over-the-counter or homeopathic remedies or herbs (like Saint John's Wort) are hard on our systems?
A: The best rule is to always have the patients check with their doctors before taking over-the-counter medication, herbals and even vitamin supplements. It's not just the cold and flu medications that can be harmful, it can be over-the-counter herbs, some prostate herbal remedies, vitamins E and C supplements -- it's not the vitamins but the supplement compound. The patients need to check (with a doctor or pharmacist) before they take these things.
Q: Do high-blood-pressure patients have other conditions (such as kidney or liver disease) that should make them wary of other products?
A: No doubt about it. With high blood pressure, they frequently have kidney disease, diabetes or a heart condition. Taking these things can move the progress (of those conditions).
Q: Does this indicate to cardiologists and their staff that they must redouble warnings or that patients take the condition lightly after living with it for a while?
A: High blood pressure patients often don't take their condition seriously. They remember their moms or dads saying 'I had it until I was 70 and the doctor told me not to worry about it.' That was when they used to just add 100 to your age and that's what your blood pressure should be. We know that's not accurate anymore, but people remember what their parents said. The other problem is that one out of four people who have high blood pressure don't even know they have it. That's why they call it 'the silent killer.' People need to get checked regularly and make sure that it's no higher than 140/90 for everybody, healthy or not, 130/80 or less if you have diabetes, and 135/85 for heart disease. Everyone just needs to get it checked.