Over-the-Counter Meds to Avoid With Hypertension


Over-the-Counter Meds to Avoid With Hypertension
from the Heart Health Center

Q: I’m finding that so many over-the-counter medications warn against taking them if you have high blood pressure. Can you tell me why and what medications I should avoid?

A: It’s funny, isn’t it? We often assume that just because a medication is available without a prescription that it must somehow be safer than prescription medications. But the reality is that all drugs can have harmful side effects. Even aspirin can increase the risk of stomach bleeding, and acetaminophen (Tylenol) can contribute to liver damage.

Thus, the decision to use a specific medication should always depend on a complete understanding of its potential risks and benefits.

You are correct. Several over-the-counter (OTC) medications can contribute to high blood pressure. Others could interact with your high blood pressure medication, making it less effective. The OTC medications to watch out for include:

Pain relievers. Non-aspirin, nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen (Motrin) and naproxen (Alleve) can increase blood pressure even if you’re already taking an anti-hypertensive medication. They appear to constrict blood vessels and increase the amount of sodium your body holds onto, both of which can cause high blood pressure. Chronic use of high-dose NSAIDs also causes kidney damage, which raises blood pressure.

Oral contraceptives. Birth control pills that contain estrogen can cause high blood pressure in about 5 percent of women who take them. That’s why women with a history of high blood pressure or other risk factors for high blood pressure such as smoking are usually warned not to take estrogen-based contraceptives. Progestin-only pills are a contraceptive option for women with high blood pressure.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.

Antihistamines and decongestants. Products containing either of these ingredients (think Benadryl and Sudafed) can increase blood pressure and interact with your blood pressure medications. Check labels of allergy, flu and cold preparations, most of which contain one or both.

Weight-loss preparation. Many of these products contain antihistamines and other substances like caffeine that can increase blood pressure. Instead of taking pills to lose weight, talk to your health care professional about lifestyle changes you can make.

Caffeine. Caffeine, which can increase blood pressure, is found in a surprising number of OTC remedies, including some aspirin formulations.

Herbal remedies. Herbal remedies that contain ephedra, found in some weight-loss supplements, can be dangerous in those with high blood pressure. Also avoid taking gingko, an herbal remedy sometimes used for memory problems, if you are also taking a thiazide diuretic. St. John’s Wort can interact with high blood pressure medications.

If you have high blood pressure, talk with your health care professional about which OTC medications and herbal remedies are safe for occasional use. Also make a point of reading the ingredient lists on OTC remedies and the inserts that come with all products.


© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.


6 Affordable and Effective Exercise Essentials


 If you need inspiration to become more physically active, a push to get going or just want to have more fun, here are six of the best, easy-to-afford and effective pieces of exercise gear.

 Using just one of these regularly will improve your fitness without straining your budget:

Resistance bands: Stretchy and fun, they do the work of weights but pack easily in a purse or pocket. Versatile for several body areas. ($3+)

Jump rope: Remember when you could jump for hours with your friends? You don’t need hours now—just 5 or 10 minutes of jumping (indoors, if you prefer) will boost your activity level and burn calories. ($3+)

Exercise mat: You’ll be more comfortable, with a safer grip, than exercising on a carpet or bare floor. That will help you be active more easily, for a longer time. ($15+)

Hand weights: Keep a set by the computer or TV and use while watching something entertaining. ($5+)

Exercise ball: Sized for your height, most of these come with their own pump for easy inflation (and reinflation). Great for strengthening various muscle groups. Use as a chair and you’ll get a bit of a workout just from balancing on it. ($15+)

Pedometer: Just put it on and in a day or two you’ll be more aware of how much (or little) you’re moving every day. Aim to increase your average daily steps by 5 percent every week until you reach 10,000 steps a day, a goal that the American Heart Association and other experts suggest. Then add more to increase benefits. ($10+)

Often, you can find fitness items such as exercise DVDs, roller skates, workout clothing and more at yard or garage sales for just a dollar or two.

If you’re interested in acquiring big home-gym equipment, yard sales and online community boards are great places to find barely used items. Recently, one site had offerings that included treadmills for $35 to $75, a weight bench for $1 and an elliptical machine for $180. Just remember that you’ll probably have to arrange for transporting the big and heavy pieces—as well as find a space for them in your home.

© 2009 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.

Women are Different – Heart Attack Symptoms in Women


Catheter Ablation Study for Atrial Fibrillation Yields Mixed Results


afib ablation

Most people who develop atrial fibrillation are first treated with medications, but medicine only works for about 50% of patients. So then what are your options?

Catheter ablation is a relatively new procedure that may help people with atrial fibrillation.  Catheter ablation is a minimally invasive procedure.  Small thin flexible catheters are passed through blood vessels to reach the heart and then deliver electrical energy that ablates (destroys) abnormal electrical tissue in the heart that is causing the abnormal heart rhythm. 

The Department of Health & Human Services and Agency for Healthcare Research and Quality recently released a report evaluating the benefits of catheter ablation procedures for people with atrial fibrillation.  The report can be found at http://www.effectivehealthcare.ahrq.gov

The report summary states that catheter ablation may “hold promise for treating atrial fibrillation” but more research is needed on this procedure, especially in women, the elderly and people with heart failure or high blood pressure.  The report found that catheter ablation has been shown to help maintain a normal heart rhythm over short periods of time (up to 1 year) but there is little evidence to show long term benefit.  Also there is no data to prove the effectiveness of catheter ablation as a first line therapy, before trialing medications to control the irregular heart rhythm.  The FDA also stated that there is no conclusive evidence of a lower stroke risk in people who undergo catheter ablation.  So patients at risk for a stroke should continue taking preventative blood-thinning medications.

Further studies are ongoing and this may be a treatment to consider in patients with atrial fibrillation but the indications and benefits should be discussed on an individual basis with your heart specialist.

For more heart healthy info please visit www.heart-strong.com

Walk or Bike to Work to Decrease Your Heart Attack Risk


ride bike

Can walking to work or riding your bicycle really lower your risk for a heart attack?

The CARDIA (Coronary Artery Risk Development in Young Adults, published in July 2009 issue of Archive of Internal Medicine) study followed over 2,300 men and women and found that active commuting to and/or from work really did help lower heart disease risk factors.  Unfortunately only 16% of people in the study actually performed active commuting on a daily basis, more men than women.

Men who actively commuted had lower triglyceride (blood fat) levels, lower blood pressures, better insulin levels, lower weights, and higher HDL (good) cholesterol levels.

The number of women who participated in active commuting was too small to determine any significant health benefits but women who performed daily physical activity had healthier numbers.

Numerous factors may not make it feasible for you to walk or bike to your place of employment.  But we always like to say that even SMALL CHANGES can make a difference.  Try getting off the bus or subway one stop earlier and walking the rest of the way to work.  If you have to drive to work, try parking your car further away from the door, which would allow some extra steps.  Take a walk at lunch time.  All Activity Counts!

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their blood pressure and other risk factors to prevent a heart attack, stroke and heart failure.  “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009.  For more info visit www.heart-strong.com

Is Obesity Becoming an Epidemic?



Obese woman

 We keep seeing in the news that more American adults (and even kids) are becoming overweight.  Is this trend heading towards an obesity epidemic?  The Centers for Disease Control recently released new statistics.  Their latest survey reports that 26.1% of US adults in 2008 were obese compared to 25.6% in 2007.  In Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia 30% or more were obese.  NJ (our home state) is below the national average at 22.9%.  Colorado was the only state with an obesity rate <20%.  Now some really sad news: no state in the US showed a significant decrease in obesity between 2007 and 2008.  Obesity increases a person risk for diabetes, heart disease and stroke.  What does the future hold for the health of Americans?!?

Our new book “Take Charge: A Woman’s Guide to a Healthier Heart” discusses risk factors for heart disease and stroke and offers tips for women to decrease their risk and their family’s risk for future heart problems. Please visit www.heart-strong.com for more info.

Carotid Artery Stenting Can Prevent Strokes


Stroke remains the third leading cause of death and first leading cause of long term disability among adult Americans.  In the United States approximately every forty-five seconds someone has a stroke.  About eighty percent of strokes are ischemic (meaning it is due to a lack of blood supply to the brain) and fifty percent of these ischemic strokes are caused by a significant carotid artery (neck artery leading up to the brain) stenosis (narrowing).  The primary cause of ischemic strokes is the development of plaque (cholesterol and fat accumulation) and then subsequent thrombus (blood clot) formation and/or debris that travels up the carotid blood vessels and occludes one of the blood vessels supplying the brain.  Cholesterol and plaque typically develops at the opening or branching of blood vessels.  The internal carotid artery travels up the neck to supply the middle cerebral and anterior cerebral artery in the brain, and if occluded can lead to a significant stroke. 

carotid artery anatomy


Carotid endarterectomy (which is a surgical procedure where cholesterol and plaque is scraped out of the neck arteries) has been the most common surgical procedure performed in the United States and the gold standard for preventing ischemic strokes.  Large randomized trials performed over the past twenty years have demonstrated the superiority of carotid artery surgery over medical therapy (medications) in preventing ischemic strokes in patients with either a symptomatic or an asymptomatic severe carotid artery narrowings.

Carotid artery angioplasty and stenting has been around for about twenty years but initial procedure results were not favorable.  Early angioplasty/stenting procedures revealed that during balloon inflation little pieces of the carotid plaque can dislodge and can travel up into the brain blood vessels and lead to a stroke.  Studies utilizing an embolic/distal protection (little umbrella or filter) device during carotid stenting found that between 7 to 145 particles would have traveled into the brain circulation during each procedure if these filters were not used.  Recent improvements in the stent technology and use of embolic/distal protection devices have now demonstrated that balloons and stents for carotid disease may be a beneficial alternative to surgery especially for high risk patients. 

carotid embolic protection device