It’s never a good feeling to be told you have high blood pressure. While the condition is common, it can lead to more serious complications, including stroke, heart attack, and kidney failure, per the Mayo Clinic. Thankfully, getting that diagnosis means you can make lifestyle changes or start taking prescription medication to help get your blood pressure back under control. If you are on blood pressure meds, however, you’ll want to take note of a recent study, which found that certain over-the-counter (OTC) medication could do serious damage. Read on to find out what medications you should never mix.
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There are a variety of medications available for high blood pressure, which is also known as hypertension. What your doctor prescribes will depend on what your actual blood pressure measurements are, as well as your overall health, the Mayo Clinic says. Often, taking two or more medications is the most effective approach, but finding the right combination can be a process of “trial and error.”
But while medication doesn’t work for patients who have resistant hypertension—which occurs when blood pressure remains high, even when taking three or more drugs—it’s certainly effective for others. Those individuals should be aware of a recent study that found there may be an additional cause for concern when taking blood pressure medications, particularly when you need something for daily aches and pains.
Researchers at the University of Waterloo in Ontario, Canada, found that those who take a diuretic and a renin-angiotensin system (RSA) inhibitor to treat high blood pressure may want to rethink taking ibuprofen for pain. Findings were published in the May 2022 edition of Mathematical Biosciences, with data suggesting that combining the three medications can cause acute kidney injury in people with specific medical profiles. In some cases, that damage can be permanent.
Often prescribed together, RSA inhibitors and diuretics are used to treat hypertension. Common brands of diuretics, also known as “water pills,” include Aldactone, Bumex, and Zaroxolyn. RSA inhibitors include both angiotensin-converting enzyme (ACE) inhibitors, which you may recognize as Lotensin, Accupril, or Monopril, and angiotensin receptor blockers (ARBs), which include brand-name products like Micardis, Atacand, and Teveten.
The most common brands of ibuprofen are available over-the-counter at drug stores, and you’ll likely know them by the brand names Advil and Motrin.
According to the study’s corresponding author, Anita Layton, PhD, Canada 150 Research Chair in mathematical biology and medicine and professor of applied mathematics, computer science, pharmacy, and biology at the University of Waterloo, the risk of acute kidney injury may have something to do with the amount of water in your body.
“Diuretics are a family of drugs that make the body hold less water,” Layton said in a press release outlining findings. “Being dehydrated is a major factor in acute kidney injury, and then the RAS inhibitor and ibuprofen hit the kidney with this triple whammy.”
The “triple whammy” she refers to occurs when a patient is taking all three medications, and study data suggests that low water intake, myogenic response (how the arteries react to changes in blood pressure), and drug sensitivity may increase the risk that patients with hypertension experience this dangerous complication.
Investigators used computer-simulated drug trials to conduct the study, which produce quicker results than human clinical trials, the press release stated. According to Layton, this approach gives healthcare providers a “head start” to better understanding drug complications.
Considering findings, researchers suggest swapping out ibuprofen for acetaminophen—commonly known by the brand name Tylenol—the next time you’re in pain. However, while these results may sound scary, Layton pointed out that complications will not necessarily occur for everyone.
“It’s not that everyone who happens to take this combination of drugs is going to have problems,” she added. “But the research shows it’s enough of a problem that you should exercise caution.”
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