Clinical Management of Drug-Induced Hypertension

2013 Practical Recommendations of the Italian Society of Hypertension (SIIA)
  • Agostino Virdis
  • Lorenzo Ghiadoni
  • Stefano TaddeiEmail author


Results from recent observational studies conducted in our country and including approximately 160,000 patients with hypertension, reported that only 37 % of patients achieve effective blood pressure control under treatment. These data confirm that blood pressure control amongst the hypertensive population is still largely unsatisfactory in Italy. For this reason, the Italian Society of Hypertension aims to generate a number of interventions to improve blood pressure control in Italy, including integrated actions with General Practitioners, the implementation of hypertension awareness in the general population, a larger use of home blood pressure measurements, and a survey aimed at identifying all clinical and excellence centers for hypertension diagnosis and treatment throughout the whole national territory. Many therapeutic agents or chemical substances can induce a persistent or transient increase in blood pressure or interfere with the effect of antihypertensive drugs, causing sodium retention and expansion of the extra-cellular volume, activating the sympathetic nervous system and inducing vasoconstriction. This aspect represents one of the most common cause of secondary forms of hypertension, which often is under-evaluated by the physicians. In this review article, the potential causes of secondary forms of hypertension caused by use/abuse of drugs or substances are summarized.


Hypertension Recommendations Drugs 


  1. 1.
    Bramlage P, Bohm M, Volpe M, Khan BV, Paar WD, Tebbe U, et al. A global perspective on blood pressure treatment and control in a referred cohort of hypertensive patients. J Clin Hypertens (Greenwich). 2010;12(9):666–77.CrossRefGoogle Scholar
  2. 2.
    Ignatius J. “RR 160/80” Scipione Riva-Rocci (1863–1937). Duodecim. 1993;109(17):1493–4.PubMedGoogle Scholar
  3. 3.
    Prugger C, Keil U, Wellmann J, de Bacquer D, de Backer G, Ambrosio GB, et al. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey. J Hypertens. 2011;29(8):1641–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Chobanian AV, Shattuck Lecture. The hypertension paradox—more uncontrolled disease despite improved therapy. N Engl J Med. 2009;361(9):878–87.PubMedCrossRefGoogle Scholar
  5. 5.
    Volpe M, Tocci G, Trimarco B, Rosei EA, Borghi C, Ambrosioni E, et al. Blood pressure control in Italy: results of recent surveys on hypertension. J Hypertens. 2007;25(7):1491–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Hartmann B, Weise H, Bassenge E. Quality assurance in Riva-Rocci blood pressure measurement: simultaneous sphygmomanometry with open and covered pressure display. Z Kardiol. 1988;77(8):537–42.PubMedGoogle Scholar
  7. 7.
    Volpe M, Rosei EA, Ambrosioni E, Cottone S, Cuspidi C, Borghi C, et al. 2012 Consensus Document of the Italian Society of Hypertension (SIIA): strategies to improve blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy. High Blood Press Cardiovasc Prev. 2013;20(1):45–52.PubMedCrossRefGoogle Scholar
  8. 8.
    Volpe M, Rosei EA, Ambrosioni E, Cottone S, Cuspidi C, Borghi C, et al. Renal artery denervation for treating resistant hypertension: definition of the disease, patient selection and description of the procedure. High Blood Press Cardiovasc Prev. 2012;19(4):237–44.PubMedCrossRefGoogle Scholar
  9. 9.
    Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens. 2007;25(9):1751–62.PubMedCrossRefGoogle Scholar
  10. 10.
    Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfield MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens. 2009;27(11):2121–58.PubMedCrossRefGoogle Scholar
  11. 11.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.Google Scholar
  13. 13.
    Grossman E, Messerli FH. Drug-induced hypertension: an unappreciated cause of secondary hypertension. Am J Med. 2012;125(1):14–22.PubMedCrossRefGoogle Scholar
  14. 14.
    White WB. Cardiovascular effects of the cyclooxygenase inhibitors. Hypertension. 2007;49(3):408–18.PubMedCrossRefGoogle Scholar
  15. 15.
    Sudano I, Flammer AJ, Periat D, Enseleit F, Hermann M, Wolfrum M, et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation. 2010;122(18):1789–96.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Agostino Virdis
    • 1
  • Lorenzo Ghiadoni
    • 1
  • Stefano Taddei
    • 1
    Email author
  1. 1.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly

Personalised recommendations