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SMG News

Seasonal Allergies and Hypertension

Last updated: Sep 21, 2015

Brisk days and brilliant foliage are autumnal delights, but many people dread one mainstay of fall flora: ragweed.  Allergy sufferers are all too familiar with the misery of autumn hay fever, usually triggered by the more than 17 varieties of ragweed that grow in North America. 1  For people with both allergies and high blood pressure, this time of year poses special concerns.  Certain allergy medications, both over the counter and prescription, are known to raise blood pressure as a side effect, so before taking a remedy for watery eyes or an itchy nose, read labels carefully—and check with your doctor.

Why do some allergy medications raise a red flag?  Allergy drugs typically contain three active ingredients to relieve symptoms:

  • Antihistamines block the production of an inflammatory chemical in the body called “histamine,” which causes nasal tissues to swell when it is released. 
  • Anti-inflammatories reduce swelling in the sinuses and nasal passages.
  • Decongestants unblock nasal passages.

Beware the “D”

Patients with hypertension should exercise caution when choosing allergy medications and pick those without decongestants as an added ingredient.  Why? Decongestants pose the most potential risk for patients with hypertension or a heart-rhythm problem (arrhythmia) because they contain one of two ingredients that can raise blood pressure and increase heart rate, most commonly, phenylephrine and pseudoephedrine.  These chemicals constrict blood vessels; they alleviate allergy symptoms by shrinking swollen membranes in the nose, and they do the same throughout the body, often causing an increase in blood pressure and even pulse rate. 2

It can be confusing, though, to distinguish between a host of OTC allergy medications, especially when they are displayed together on pharmacy shelves.   One helpful tip is to watch for the letter “D” after the name of the drug.  When manufacturers add the letter “D” after the brand name it indicates that the remedy contains a decongestant as well as an antihistamine. For example, Allegra-D, Zyrtec-D, and Claritin-D, all have pseudoephedrine. 3

Antihistamines and anti-inflammatories

While generally safer than decongestants, antihistamines may also be detrimental to patients with high blood pressure. The U.S. Food and Drug Administration cautions that “antihistamines taken in conjunction with blood pressure medication may cause a person's blood pressure to increase and may also speed up the heart rate.” 4

Anti-inflammatory allergy drugs such nasal steroids—for example, the over-the-counter drug Nasonex—are generally not as concerning for patients with hypertension or arrhythmias; however, must be taken in the exact dose prescribed or may cause water retention, especially harmful for people with high blood pressure. 5

"I advise patients with seasonal allergies to check with their physician before taking over-the-counter medications,” says Summit Medical Group nephrologist Ellen Lunenfeld, MD.  “It’s important to know if there will be a drug-on-drug response between the cardiac medication and the allergy medication.”

A drug-on-drug response is catalyzed when medications interact together.  But you can still find relief from allergy symptoms, safely, even if you have heart problems.

"There are prescription medications that are generally well tolerated when used in conjunction with heart medications,” Lunenfeld says.  “Talk over your options at your next a visit with your cardiologist or other health care provider. If you can, bring the allergy medications with you or at least have a list of them.”

One safeguard against mixing meds unadvisedly is to fill all your prescriptions at the same pharmacy. This way, the staff has a complete list of your medications on file.

Natural Allergy Solutions

Pharmaceutical products work well to control allergy symptoms, but there are also natural ways to alleviate symptoms.  Because allergies are an immune response to a foreign irritant, one of the most effective and safe ways to fight allergies is to rid your body and your environment of allergens.  You can also use complementary medicine practices to bolster your immune system.  Here are some nondrug options to consider, either alone or with an OTC remedy:

  • An air conditioner can help filter out ragweed pollen and make indoors more comfortable. 
  • Food choices are important in controlling, and preventing, an allergic response to pollen.  Dairy products—even healthy ones like plain, nonfat yoghurt—and sugar are known to trigger mucus production.  Too much mucus aggravates allergies.
  • Ginger tea, made from boiled ginger root, is a traditional Asian cold and allergy fix. 
  • Acupuncture from a medically certified practitioner has been shown in medical studies to bring relief from allergies and recurring sinus infections in some patients.

Seasonal allergies can make you sneezy and sluggish, but keep heart health in mind when seeking symptom relief.


  1. Williamson, Joey. "Goldenrod & Ragweed." HGIC 2326 : Extension : Clemson University : South Carolina. Clemson University, 7 Aug. 2013. Web. 05 Sept. 2015.
  2. Institute, Oklahoma Heart. "What Allergy Medicines Can I Take If I Have Heart Disease." Web log post. Oklahoma Heart Institute, 7 July 2014. Web. 2 Sept. 2011.
  3. ibid
  4. FDA, US. "U.S. Food and Drug Administration." Drug Interactions: What You Should Know. FDA, 9 Dec. 2014. Web. 04 Sept. 2015.
  5. ibid