How Prednisone Affects Blood Pressure and Managing Blood Pressure While On It

Key takeaways:

• Prednisone can increase blood pressure by causing fluid retention and increasing sodium levels. Weight gain from prednisone can further increase blood pressure.
• The impact of this medication on blood pressure depends on the dose, duration, and individual factors.
• Lifestyle changes, such as reducing salt intake and exercising, can help manage blood pressure. Regular blood pressure monitoring is also essential while on prednisone.
• Your doctor may adjust the prednisone dosage or prescribe blood pressure medication if needed.

Prednisone is a synthetic medicine that belongs to the group of medications known as corticosteroids. It exerts its effects by activating cortisol (a hormone that regulates inflammatory and immune responses).

Prednisone is chemically inactive and is transformed into its active form prednisolone in the liver. It acts as an analgesic (pain reliever), immunosuppressive, and anti-inflammatory agent, treating a variety of conditions, such as skin diseases, arthritis, and allergies.

Does prednisone increase blood pressure?

Yes, prednisone can raise blood pressure. In fact, high blood pressure is a common side effect of prednisone. This medication causes fluid retention and an increase in sodium levels, resulting in high blood pressure in some people.

Prednisone is usually mild to moderate but can be more significant in people with heart issues, pre-existing hypertension, and those who are using this medicine for a long time or are taking higher doses of it. 

How does prednisone raise blood pressure?

An increase in blood pressure due to prednisone can be because of the following reasons:

• Fluid retention: Prednisone causes the body to retain fluid, resulting in increased blood volume and pressure.
• Sodium retention: Prednisone causes the kidneys to increase sodium reabsorption, leading to increased fluid retention and blood pressure.
• Obesity: Increased weight or obesity can also be the reason for increased blood pressure. Prednisone makes people feel hungrier, which can lead to eating more and gaining weight over time, which is a risk factor for high blood pressure.

How to prevent high blood pressure when on prednisone?

If you are experiencing high blood pressure while taking prednisone, the following measures can be help manage your blood pressure:

1. Reduce sodium intake

Reducing your sodium intake, especially in the form of table salt, can help manage high blood pressure. Aim to keep your daily sodium consumption under 2 grams (or 2,000 milligrams). This target includes avoiding processed foods. Sodium is naturally found in foods, canned soups, and salty snacks.

2. Increase potassium-rich foods

Potassium can help balance sodium levels and lower blood pressure. So, try consuming foods rich in potassium such as bananas, spinach, sweet potatoes, avocados, and oranges.

3. Exercise regularly

Engage yourself in physical activity such as moderate exercise, swimming, or cycling for at least 30 minutes most days.

4. Avoid alcohol

Limit caffeine and alcohol consumption as they are linked to high blood pressure.

5. Stay hydrated

Drink enough water throughout the day to help manage fluid retention.

6. Medication adjustments

Check your blood pressure regularly, especially if you're prone to hypertension. Your doctor might adjust your prednisone dosage or prescribe antihypertensive medications if necessary.

Alternative treatments to prednisone that do not cause hypertension

Here are alternative treatments to prednisone that are less likely to cause or contribute to hypertension, depending on the condition being treated:

Non-steroidal anti-inflammatory drugs (NSAIDs)

Inflammatory conditions such as arthritis or muscle injuries can be treated with NSAIDs such as Ibuprofen and Celecoxib as they are generally safer for blood pressure than corticosteroids but should be used with caution during long-term therapy.

Topical or localized treatments

For treating skin conditions and joint inflammation, topical (skin applied) corticosteroids such as hydrocortisone cream are often used as they have minimal absorption, reducing the risk of high blood pressure.

Immunosuppressants

For autoimmune disorders such as lupus or vasculitis, your doctor may prescribe drugs that suppress the immune system(immunosuppressants) such as Azathioprine as they control inflammation without significant fluid retention.

Lifestyle and natural anti-inflammatory approaches

Lifestyle changes can help prevent high blood pressure, especially when using prednisone. A healthy diet with fruits, vegetables, whole grains, healthy fats, and omega-3 fatty acid rich foods like fish and flaxseeds can reduce inflammation.

Supplements like turmeric, omega-3s, and Boswellia may also help. Regular exercise and physical therapy improve joint health and support blood pressure management.

Other side effects of prednisone

Prednisone can cause a range of side effects, which varies from person to person depending on the dose, duration of use, and individual sensitivity.

Common side effects

Side effects that are common with prednisone use include:

• Increased appetite
• Weight gain (due to fluid retention and increased fat storage)
• Mood Changes (irritability, anxiety, or mood swings)
• Insomnia (difficulty falling asleep)
• Swelling (particularly in the face, hands, or ankles, causing a "moon face" appearance)
• Increased blood sugar levels

Less common but serious side effects

Other less common but serious side effects of prednisone include:

• Increased susceptibility to infections (weakened immune system)
• Osteoporosis (bone thinning, increasing the risk of fractures with prolonged use)
• Muscle weakness 
• Eye problems (cataracts or glaucoma with long-term use)
• Delayed wound healing (slower recovery from injuries or surgeries)
• Hormone suppression (stopping prednisone suddenly can cause low cortisol, leading to fatigue, weakness, or dizziness)

When to seek medical attention

If you are on prednisone, consider seeking medical care if you experience:

• Persistent or severe headaches
• Chest pain, difficulty breathing, or an irregular heartbeat
• Sudden or extreme spikes in blood pressure
• Swelling in your face, hands, or legs
• Unexplained muscle weakness or severe fatigue
• Signs of infection, like fever, chills, or persistent sore throat

Reach out to your healthcare provider if you experience any of the above-mentioned symptoms while taking prednisone. They may adjust the dosage of prednisone or recommend alternative treatment plans for your condition.

Wrap up

In summary, prednisone can influence blood pressure by promoting fluid retention and disrupting electrolyte levels. These changes may result in higher blood pressure, especially with prolonged or high-dose treatment.

Individuals on prednisone need to keep track of their blood pressure and follow medical guidance, which may include lifestyle adjustments or additional medications to address any side effects.