What are the effects of Kratom on blood pressure?

Effects of Kratom on Blood Pressure

Kratom (Mitragyna speciosa) can cause significant cardiovascular effects including hypertension, with regular use associated with dose-dependent increases in blood pressure that may lead to serious cardiovascular complications. 1

Cardiovascular Effects of Kratom

Acute Effects

• Hypertension: Kratom is associated with acute increases in blood pressure, with tachycardia and hypertension being among the most common adverse cardiovascular effects reported to poison centers 1
• Sympathetic Activation: Kratom's stimulant properties at lower doses can increase sympathetic nervous system activity, leading to elevated blood pressure 2
• Dose-Dependent Effects:
  • Lower doses (1-5g): Primarily stimulant effects with increased blood pressure
  • Higher doses (5-15g): More opioid-like effects, but still with potential cardiovascular impact 2

Chronic Effects

• Prolonged QTc Interval: Regular kratom consumption can induce increased QTc intervals in a dose-dependent manner 1
• Serious Cardiovascular Complications: Long-term use has been associated with:
  • Coronary atherosclerosis
  • Myocardial infarction
  • Hypertensive cardiovascular disease
  • Left ventricular hypertrophy
  • Cardiac arrhythmia
  • Cardiomegaly 1

Risk Factors for Kratom-Induced Hypertension

The following factors may increase the risk of experiencing blood pressure elevation with kratom:

• Polysubstance use: Combination with other substances significantly increases cardiovascular risks 1, 3
• Pre-existing hypertension: Those with baseline elevated blood pressure may experience more pronounced effects 4
• Older adults: More susceptible to blood pressure increases 4
• Renal disease: May exacerbate blood pressure effects 4
• Concurrent use of antihypertensive medications: May interfere with blood pressure control 4
• Product adulteration: Kratom products may be adulterated with other substances that can cause additional cardiovascular effects 5

Clinical Implications

Monitoring Recommendations

• Regular blood pressure monitoring is essential for individuals using kratom, especially those with:
  • Pre-existing cardiovascular conditions
  • Hypertension
  • Taking medications that may interact with kratom 4

Warning Signs of Serious Cardiovascular Effects

• Severe headache
• Chest pain
• Palpitations
• Shortness of breath
• Dizziness or lightheadedness 1, 3

Potential Complications

• Hemorrhagic stroke: Case reports have linked kratom use (particularly adulterated products) with intracerebral hemorrhage 5
• Ventricular arrhythmia: Associated with kratom consumption, especially when combined with other substances 1
• Cardiopulmonary arrest: Reported in severe cases, though often with polysubstance use 1, 6

Clinical Recommendations

• Avoid use: The FDA has warned against kratom use due to potential for serious adverse effects 7
• Discontinuation: For patients using kratom who develop hypertension, discontinuation is the primary intervention 4
• Electrolyte monitoring: Check potassium levels in patients using kratom who present with hypertension 4
• Medication adjustment: Antihypertensive medications may need adjustment if kratom use continues or after cessation 4
• Screening: Healthcare providers should screen for kratom use in patients with unexplained hypertension or resistant hypertension 7

Important Caveats

• Many reported severe cardiovascular effects involve polysubstance use, making it difficult to isolate kratom's specific contribution 1, 3
• The quality and purity of kratom products vary widely, with potential for contamination or adulteration 5
• Individual responses to kratom may vary based on genetics, underlying health conditions, and concurrent medications 3
• Research on kratom's cardiovascular effects remains limited, with few controlled clinical studies 1, 6