Does Algesal Baum (capsaicin) ointment increase Blood Pressure (BP)?

Does Algesal Baum Ointment Increase Blood Pressure?

Algesal Baum ointment, which contains capsaicin, does not typically cause significant increases in blood pressure when used topically as directed, though individual responses may vary.

Mechanism and Effects of Capsaicin on Blood Pressure

Capsaicin, the active component in Algesal Baum, has complex effects on blood pressure that depend on:

1. Route of administration:

   • Topical application generally has minimal systemic effects
   • Intravenous or oral administration may have more pronounced effects on blood pressure

2. Physiological effects:

   • When applied topically, capsaicin can actually attenuate blood pressure increases during muscle contraction 1
   • The mechanism involves affecting sensory nerve fibers (groups III and IV muscle afferents) that contribute to the exercise pressor reflex

Clinical Evidence

Research on capsaicin's effects on blood pressure shows mixed results:

• In one study, topical analgesic balm containing capsaicin actually attenuated the mean arterial pressure response to muscle contraction 1

• Another study found that combined administration of capsaicin and isoflavone:

  • Did not change blood pressure in normotensive individuals
  • Significantly reduced blood pressure in hypertensive individuals 2

• However, a case report described an arterial hypertensive crisis following abundant ingestion of chili peppers (containing high amounts of capsaicin) 3, suggesting that very high oral doses might affect blood pressure

Considerations for Clinical Practice

When evaluating medications and substances that may affect blood pressure, clinicians should:

• Screen all patients with hypertension for substances that may increase BP or interfere with antihypertensive medications 4

• Consider that the individual effect of substances on BP can be highly variable, with greater increases noted in:

  • Elderly patients
  • Those with higher baseline BP
  • Patients using antihypertensive therapy
  • Patients with kidney disease 4

Conclusion

When used as directed topically, Algesal Baum ointment is unlikely to cause significant increases in blood pressure in most patients. The evidence suggests that topical capsaicin may even have beneficial effects on blood pressure regulation in some contexts.

If a patient with hypertension is concerned about using Algesal Baum, monitoring blood pressure before and after initiating treatment would be a reasonable precaution, particularly in those with poorly controlled hypertension or who are at high cardiovascular risk.