Can a Common Cold Cause a Blood Pressure of 147/87?
Yes, a common cold can contribute to a blood pressure reading of 147/87 in a patient with stage 1 hypertension, though this is typically a modest and temporary elevation rather than the primary cause of sustained hypertension.
Mechanisms of Cold-Related Blood Pressure Elevation
The common cold can elevate blood pressure through several pathways:
Direct inflammatory response: Viral upper respiratory infections trigger inflammatory mediators that increase sensitivity of afferent sensory nerves in the upper airway, which may affect autonomic regulation of blood pressure 1
Sympathetic activation: The acute illness state and associated discomfort can activate the sympathetic nervous system, leading to transient blood pressure increases 2
Medication effects: Over-the-counter cold medications containing decongestants (pseudoephedrine, phenylephrine, phenylpropanolamine) can cause mild to significant blood pressure elevation through alpha-adrenergic stimulation 1, 3, 4
Clinical Context for Your Reading
A blood pressure of 147/87 mmHg represents:
Stage 1 hypertension by current classification (systolic 130-139 or diastolic 80-89 mmHg) 1
A modest elevation that could reasonably be explained by the combination of underlying stage 1 hypertension plus the acute stress of a viral illness 2
Evidence on Cold-Related Blood Pressure Changes
Research demonstrates that hypertensive patients experience more pronounced cardiovascular responses to cold-related stressors:
Cardiorespiratory symptoms: Hypertensive patients with or without other cardiovascular disease experience significantly increased cold-related dyspnea, chest pain, and arrhythmias compared to normotensive individuals 2
Magnitude of effect: While the studies primarily examined environmental cold exposure rather than viral colds specifically, they show that hypertensive patients have exaggerated blood pressure responses to cold-related stressors 5
Critical Medication Considerations
If you are taking any over-the-counter cold medications, check the ingredients immediately:
Avoid oral decongestants: Pseudoephedrine, phenylephrine, and phenylpropanolamine can elevate blood pressure and should be avoided in patients with hypertension 1, 3, 4
Safe alternatives: Second-generation antihistamines like cetirizine do not elevate blood pressure and are appropriate for hypertensive patients 3
Combination products: Many cold preparations contain both antihistamines AND decongestants—ensure you are not inadvertently taking a sympathomimetic agent 3
What You Should Do
Monitor your blood pressure after recovery:
Recheck your blood pressure 1-2 weeks after the cold resolves to determine your true baseline 1
If blood pressure remains elevated (≥130/80 mmHg on multiple occasions), this represents persistent stage 1 hypertension requiring lifestyle modification and possibly pharmacological treatment 1
The cold may have unmasked underlying hypertension rather than causing it 2
Avoid decongestants:
Use only antihistamines without sympathomimetic activity for symptom relief 3, 4
If nasal congestion is severe, topical decongestants (oxymetazoline) for less than 3 days are safer than oral agents 3
Continue any existing antihypertensive medications:
- Do not discontinue blood pressure medications during acute illness unless specifically instructed by your physician 3
Common Pitfalls to Avoid
Do not assume the cold is the sole cause: A reading of 147/87 suggests underlying hypertension that requires evaluation even after the cold resolves 1, 2
Do not use "white coat effect" as reassurance: While blood pressure can be transiently elevated in medical settings, persistent readings in this range require action 1
Do not ignore medication labels: The American Academy of Pediatrics guidelines note that severe hypertension has been observed as an idiosyncratic response to appropriate dosing of decongestants, not just with excessive doses 1