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Cardiovascular Effects of Pseudoephedrine in Medically Controlled Hypertensive Patients
MAJ Richard A. Beck, MC;
CPT Donna L. Mercado, MC;
CPT Sharon M. Seguin, MC;
COL W.P. Andrade, MC;
LTC Howard M. Cushner, MC
Arch Intern Med. 1992;152(6):1242-1245.
Abstract
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Background.—
Oral sympathomimetics are effective in the treatment of nasal congestion through stimulation of  adrenergic receptors in the blood vessels of the nasal mucosa. This vasoconstrictor activity has resulted in the general recommendation that such pressor amines not be used in patients with hypertension. No prospective studies have examined the safety of sustained-release pseudoephedrine in hypertensive patients.
Methods.—
Volunteers (N = 28) with controlled hypertension participated in a randomized, double-blind, placebo-controlled, crossover study that examined the cardiovascular effects of 120 mg of sustained-release pseudoephedrine taken on a twice daily basis. Physicianinvestigators measured blood pressure and heart rate using mercurial sphygmomanometers during acute and steadystate phases. Compliance was verified with pill counts and serum drug levels. Symptom questionnaires were completed by the volunteers.
Results.—
While a strong statistical correlation was found over time, with minimal increases in mean arterial pressure and heart rate, pseudoephedrine administration did not result in statistically significant changes in any cardiovascular parameter. Mild disturbances in sleeping pattern and urinary retention in some male subjects were the only significant symptoms detected.
Conclusions.—
We conclude that while sustained-release pseudoephedrine appears safe for the majority of medically controlled hypertensive patients without statistically significant effects on blood pressure or heart rate our studies did show an upward trend in these parameters which, in a larger population of hypertensive patients, may prove to be clinically significant.
(Arch Intern Med. 1992;152:1242-1245)
Author Affiliations
USA; USA; USA; USA; USA
From the Departments of Otolaryngology-Head and Neck Surgery (Dr Beck), Internal Medicine (Drs Mercado and Seguin), Allergy and Immunology (Dr Andrade), and Nephrology Service (Dr Cushner), Madigan Army Medical Center, Tacoma, Wash.
Footnotes
Accepted for publication December 31, 1991.
Presented at the 94th annual meeting of the American Laryngological, Rhinological, and Otological Society Inc, Waikaloa, Hawaii, May 8, 1991.
The opinions or assertions contained herein are the private views of the authors and should not be construed as official or as reflecting the views of the US Department of the Army or the Department of Defense.
Reprint requests to the Nephrology Service, Madigan Army Medical Center, Tacoma, WA 98431-5000 (Dr Cushner).
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