From the Research
Phenylephrine does not significantly affect blood pressure in most individuals, according to the most recent and highest quality study available 1. When considering the impact of phenylephrine on blood pressure, it's essential to look at the most recent and reliable evidence. The study published in 2018 in The Journal of Emergency Medicine 1 found that intranasal vasoconstrictors, including phenylephrine, did not significantly increase blood pressure in patients without a history of hypertension. This study's findings are crucial because they directly address the question of phenylephrine's effect on blood pressure.
Key points to consider:
- The 2018 study 1 was a randomized, double-blind, placebo-controlled trial, which is a high level of evidence.
- The study found no significant differences in mean arterial pressure over time between phenylephrine and saline groups.
- The mean greatest increases from baseline in mean arterial pressure, systolic and diastolic blood pressure, and heart rate for each treatment group were also not significantly different from the saline group.
In contrast to older studies or those with less direct relevance, this recent study provides the most up-to-date and reliable information on the topic. For example, a study from 1982 2 investigated the effects of intranasally administered phenylephrine on blood pressure in patients with chronic nasal congestion and those with hypertension, finding no significant changes in blood pressure or heart rate. However, the 2018 study 1 is more relevant due to its recency and design.
It's also worth noting that other studies, such as one from 1985 3, discuss the potential of sympathomimetic decongestants, including phenylephrine, to elevate blood pressure, but these warnings are based on the mechanism of action rather than direct evidence from high-quality, recent studies like the one from 2018 1.
Therefore, based on the most recent and highest quality evidence, phenylephrine can be considered safe in terms of its effect on blood pressure for most individuals, including those without a history of hypertension 1. However, as with any medication, it's crucial for patients to discuss their specific health conditions and concerns with their healthcare provider.