A novel protocol to assess the impact of prescription stimulants on blood pressure in adults using ambulatory blood pressure monitoring

J Clin Hypertens (Greenwich). 2021 Jun;23(6):1264-1268. doi: 10.1111/jch.14250. Epub 2021 May 3.

Abstract

Prescription stimulants are an important cause of secondary hypertension and their use is increasing in adult patients who are also at risk for essential hypertension. Although stimulants increase blood pressure, a systematic approach for assessing their impact in individual patients is lacking. We developed a protocol using ambulatory blood pressure monitoring for up to 36 h to compare blood pressure over two sequential days. Average blood pressure on the first day (without stimulant medication) was compared to average blood pressure on the second day (after re-starting stimulant medication). We describe the outcomes of this protocol for a case series of eleven adults. Patients demonstrated one of three outcomes: normal blood pressure on both days, hypertension on both days, or hypertension only on the day patients received their stimulant medications. This novel protocol provides valuable information on the blood pressure effects of stimulant medications and allows clinicians to make personalized decisions regarding treatment.

Keywords: ambulatory blood pressure monitoring; blood pressure; hypertension; prescription stimulants; secondary hypertension.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Central Nervous System Stimulants* / adverse effects
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Prescriptions

Substances

  • Central Nervous System Stimulants