Risk of Increased Blood Pressure with Prednisone

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Risk of Increased Blood Pressure with Prednisone

Question:

Is there any risk for someone with high blood pressure to start taking prednisone?

Answer

Yes, there is some risk of increased blood pressure.

Even among people with normal blood pressure, corticosteroids, such as prednisone, can increase blood pressure. One reason is that prednisone tends to cause fluid retention. When a person with high blood pressure retains fluid, due to high salt intake or any other reason, blood pressure can rise. That's one reason that a "heart healthy" diet for people with high blood pressure or heart disease is one that's low in salt.

People taking prednisone should have their blood pressure monitored regularly, especially people with high blood pressure. And if you have symptoms of dangerously high blood pressure (including severe headache, blurred vision or confusion), seek medical attention right away. Fortunately, severe elevations of blood pressure related to prednisone are rare.

The good news is that when blood pressure rises after treatment with prednisone, reducing the dosage to the lowest necessary amount is effective at lowering the blood pressure back to normal.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Last updated:	July 20, 2009