From the Guidelines
Yes, blood pressure can increase during detoxification, particularly when withdrawing from substances that affect the nervous system. This occurs because the body's nervous system, which was suppressed by these substances, becomes hyperactive during withdrawal, releasing stress hormones like adrenaline and noradrenaline, causing blood vessels to constrict and heart rate to increase, resulting in elevated blood pressure 1. The 2020 International Society of Hypertension Global Hypertension Practice Guidelines recommend screening all patients for substances that may increase blood pressure or interfere with the blood pressure-lowering effect of antihypertensive medications 1.
Some key points to consider during detoxification include:
- Medical supervision is essential, especially for those with existing hypertension or cardiovascular issues
- Healthcare providers may prescribe medications like clonidine or benzodiazepines to manage blood pressure spikes or ease withdrawal symptoms
- Staying hydrated, maintaining electrolyte balance, and avoiding caffeine can help minimize blood pressure fluctuations during detox
- Blood pressure typically normalizes as the body adjusts to the absence of substances, though this may take days to weeks depending on the substance and duration of use
It's also important to note that certain substances, such as liquorice, oral contraceptives, steroids, non-steroidal anti-inflammatory drugs, cocaine, and amphetamines, can raise blood pressure, and their use should be monitored carefully 1. Additionally, over-the-counter medications, prescription medications, alternative therapies, dietary products, and recreational drugs can also increase blood pressure, and their intake should be inquired about when a patient has elevated blood pressure measurements 1. The most recent and highest quality study, the 2020 International Society of Hypertension Global Hypertension Practice Guidelines, provides the best guidance on managing blood pressure during detoxification 1.
From the Research
Blood Pressure During Detoxification
- Blood pressure can increase during detoxification, as observed in patients undergoing alcohol withdrawal 2, 3.
- Studies have shown that blood pressure elevations during alcohol withdrawal may predict future blood pressure abnormalities 2.
- The pressor effect of alcohol withdrawal could be due to sympathetic nervous system overactivity or possibly to hypercortisolaemia 3.
- In patients admitted for alcohol detoxification, blood pressure was elevated in 49% of cases, with 32% having a blood pressure of 160/95 mmHg or more 3.
Factors Influencing Blood Pressure During Detoxification
- The severity of alcohol withdrawal symptoms is significantly related to the height of both systolic and diastolic blood pressures 3.
- Plasma cortisol levels correlate with systolic but not diastolic pressure, while urinary volume is inversely correlated with the height of the diastolic pressure 3.
- No relationship was found between blood pressure and plasma renin activity or plasma aldosterone levels 3.
Detoxification and Blood Pressure in Other Contexts
- Detoxification is a vital cellular task that, if lacking, can lead to early morbidity and mortality 4.
- The process of detoxification involves the mobilization, biotransformation, and elimination of toxicants of exogenous and endogenous origin 4.
- Hemabsorption, a detoxifying treatment, did not improve neurologic recovery in dogs after cardiac arrest, suggesting that more prolonged hemabsorption and more encompassing detoxification treatments may be needed 5.