Everyday Pain Relief: High Blood Pressure

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Many common over-the-counter drugs taken for pain can push your high blood pressure even higher. Here's what you need to know.

By R. Morgan Griffin
WebMD Feature

Reviewed By Charlotte Grayson

In recent months, the risks from popular prescription pain relievers such as Vioxx, Celebrex, and Bextra have grabbed headlines. But you may not realize that many over-the-counter pain relief drugs also pose some serious risks.

That's especially true for people with high blood pressure. Many over-the-counter (OTC) painkillers can push your blood pressure higher. They can even be dangerous. Since high blood pressure has no symptoms that you can feel, you may be hurting yourself without realizing it.

"People with high blood pressure don't know the risks of taking some of these painkillers," says Nieca Goldberg, MD, a cardiologist and spokesperson for the American Heart Association. "They assume that anything you can buy over the counter is safe. But these drugs are chemicals that can cause side effects."

The problem isn't only with OTC painkillers. In fact, many remedies for colds, sinus problems, and even heartburn contain the same ingredients.

If you have high blood pressure, keeping it under control is crucial. So, before you grab a bottle of pain reliever for your next backache, learn some dos and don'ts.

How Do Pain Relief Drugs Work?

In a certain way, all pain is in your head. When we feel pain, it's the result of an electrical signal being sent from the nerves in a part of your body to your brain.

But the whole process isn't electrical. When tissue is injured (by a sprained ankle, for instance), the cells release certain chemicals in response. These chemicals cause inflammation and amplify the electrical signal coming from the nerves. As a result, they increase the pain you feel.

Painkillers work by blocking the effects of these pain chemicals. The problem is that you can't focus most pain relievers specifically on your headache or bad back. Instead, it travels through your whole body. This can cause some unexpected side effects.

What Are the Risks for People with High Blood Pressure?

For people with high blood pressure, some types of nonsteroidal anti-inflammatory drugs (NSAIDs) can be risky. They include ibuprofen, naproxen sodium, and ketoprofen, the active ingredients in medicines like Advil and Aleve.

Other pain relievers may be less dangerous. Aspirin is also an NSAID, but experts think that it's safer for people with hypertension. Acetaminophen -- the active ingredient in Tylenol -- is a different type of painkiller that doesn't raise blood pressure as a side effect. However, like any drug, it does have side effects of its own. You shouldn't take any over-the-counter painkiller for more than 10 days without your health care provider's approval.

Why are people with high blood pressure at special risk? Some of these NSAIDs reduce the blood flow to the kidneys. The kidneys -- which filter your blood -- work more slowly, and so fluid builds up in your body. The increased fluid drives up your blood pressure.

"When I have patients with heart disease that suddenly gets much worse," Goldberg tells WebMD, "the first thing I ask them is if they've used an over-the-counter pain medicine."

These drugs have additional risks. If you take them often enough and at a high enough dose, they can seriously damage the kidneys.

So, what's a person with high blood pressure and a headache to do? In general, people with high blood pressure should use acetaminophen or possibly aspirin for over-the-counter pain relief.

Unless your health care provider has said it's OK, you should not use ibuprofen, ketoprofen, or naproxen sodium. If aspirin or acetaminophen doesn't help with your pain, call your doctor.

Other Options for Pain Relief

Of course, painkillers aren't the only answer for many of life's aches and pains. Many effective and safe alternatives don't have any side effects at all.

• Ice packs, for acute injuries like a sprained ankle, can keep down swelling and ease pain.
• Heat -- with a hot towel or heating pad -- can be helpful for treating chronic overuse injuries. (However, you shouldn't use heat on recent injuries.)
• Physical activity can help reduce some kinds of discomfort, such as arthritis pain.
• Relaxation -- with techniques like yoga or meditation -- may reduce pain. Biofeedback may help as well. These approaches are best for pain that's amplified by stress, like tension headaches.
• Nontraditional techniques with low risks -- like acupuncture -- benefit some people.

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