How steroids affect blood pressure
Steroids are life-changing medications for autoimmune and inflammatory conditions such as rheumatoid arthritis, lupus, asthma and Crohn’s disease, but they can also lead to side effects that need to be carefully monitored and managed. If you've been prescribed a steroid like prednisone or prednisolone, it's important to understand that it might affect your blood pressure.
Steroids can cause or worsen hypertension (high blood pressure) due to their effects on various bodily systems:
1. Fluid retention and electrolyte imbalance
Steroids can lead to the body holding on to too much water and sodium (salt) than necessary. This is known as water retention or edema and can be noticeable as swelling or puffiness in the legs and hands. The higher levels of water and salt in the body lead to an increase in the volume of the blood (the space it takes up inside your blood vessels) An expanded blood volume puts more pressure on your blood vessels from the inside, raising your blood pressure.
2. Increased sensitivity to certain hormones
Steroids may enhance the effects of certain hormones such as adrenaline, causing your blood vessels to constrict (shrink). This can also contribute to a rise in your blood pressure.
3. Weight gain
Steroids can cause weight gain that can also contribute to hypertension (high blood pressure). You can read more about this in our weight gain article.
Why does this happen?
Prescribed steroids act like cortisol, a steroid hormone naturally produced by the body’s adrenal glands. Cortisol is essential for regulating how we turn food into energy, how we respond to stress, and the proper functioning of our immune system (including reducing inflammation). However, having more than the body’s normal level of cortisol - as a result of steroid medication - can be problematic, leading to:
Increased sodium retention
Sodium (salt) is an essential nutrient but too much of it can cause your body to hold on to fluids that can increase your blood volume and blood pressure.
Reduced potassium levels
Potassium is another essential nutrient. It’s crucial for balancing your sodium (salt) levels and helping you maintain normal blood pressure. Steroids can trick your body into dropping its potassium levels, which can make a high blood pressure problem worse.
What to look out for
Many patients who begin taking steroids to treat an inflammatory disease encounter challenges with high blood pressure. Patients who have a history of hypertension are at particular risk, as the addition of steroids to a treatment plan can make some pre-existing conditions worse.
Patients who are already on medications for high blood pressure may need to increase their dose or even add new high blood pressure medications. In addition, the start of a steroid treatment course can also reveal a tendency toward high blood pressure in a patient who is not previously known to have the condition. For these reasons, regular checks of blood pressure are absolutely crucial following the start of a steroid course.
Keep track of your blood pressure and discuss it regularly with your doctor.
Top tips for managing hypertension
Here are some practical steps you can take to stay on top of your blood pressure while taking steroids:
1. Monitor your blood pressure regularly
Check your blood pressure at home with a reliable monitor. Track your readings and share them with your doctor to ensure timely adjustments to your treatment plan.
2. Try to limit your sodium (salt) intake
Try to avoid processed foods, canned soups and salty snacks.Experiment with using herbs and spices for flavor instead of salt.
3. Boost your potassium intake
Aim to eat potassium-rich foods like bananas, spinach, sweet potatoes and avocados as part of your regular diet. Ask your doctor if potassium supplements are right for you.
4. Do your best to stay active
Regular, moderate exercise like walking or swimming can really help.
5. Try to maintain a healthy weight
Focus on a balanced diet with plenty of fruits, vegetables and lean proteins (like chicken and beans). Avoid sugary foods and drinks that can contribute to weight gain.
6. Stay hydrated
Drink plenty of water to flush out excess sodium (salt). Limit alcohol consumption, as it can raise your blood pressure.
7. Take steps to manage your stress levels
Relaxation techniques like deep breathing, meditation or yoga can make a big difference. Make time for the things that you enjoy. These vary from person to person but may include reading, meeting with friends, or simply walking or sitting in nature.
8. Speak with your doctor
Be sure to discuss any concerns about your blood pressure or side effects with your healthcare provider. Your doctor may adjust your steroid dose or prescribe specific blood pressure medications.
The bottom line
While steroids can increase blood pressure, they are key for managing many autoimmune and inflammatory conditions. By making lifestyle changes around diet, exercise and stress, it is possible to manage steroid-induced hypertension and reduce your risk levels.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.