From the Guidelines
Valium can cause a drop in blood pressure, particularly when administered intravenously or in higher doses. As a benzodiazepine, Valium's primary effects are sedation, muscle relaxation, and anxiety reduction, but it may also produce a mild hypotensive effect by decreasing peripheral vascular resistance and cardiac output 1. According to the study published in Pediatrics, IV/IM administration of diazepam may cause hypotension, especially when used in combination with other sedative agents 1. Key points to consider include:
- Valium's blood pressure effects are more pronounced in people with existing cardiovascular conditions, elderly individuals, or those taking other medications that lower blood pressure
- Combining Valium with alcohol, opioids, or other central nervous system depressants can enhance its hypotensive effects
- It is essential to take Valium exactly as prescribed and inform healthcare providers about all other medications being taken to minimize potential blood pressure effects
- Monitoring oxygen saturation and respiratory effort is crucial when administering Valium, especially when given rapidly IV or in combination with other sedative agents 1
From the FDA Drug Label
Cardiovascular System:hypotension The diazepam drug label directly mentions hypotension as a reported side effect, which indicates that Valium can drop blood pressure 2.
- Hypotension is listed under the Cardiovascular System category of adverse reactions.
- This suggests that diazepam may cause a decrease in blood pressure in some patients.
From the Research
Effects of Valium on Blood Pressure
- The study 3 found that diazepam (Valium) produces coronary vasodilation and decreases systemic vascular resistance, which can lead to a decrease in blood pressure.
- Another study 4 found that diazepam produced a significant fall in aortic systolic and left ventricular end-diastolic pressures, indicating a potential decrease in blood pressure.
- A systematic review and meta-analysis 5 found that benzodiazepines, including Valium, may have antihypertensive properties and can reduce blood pressure in the short term.
Mechanism of Action
- The study 3 suggests that diazepam augments myocardial contractility by increasing coronary blood flow, which can lead to a decrease in blood pressure.
- The study 5 proposes that benzodiazepines may have a hypotensive effect via potentiation of the inhibitory effect of gamma-amino butyric acid (GABA) in the central nervous system and vasodilatory properties.
Clinical Implications
- The study 4 found that diazepam has little effect on basal circulatory and respiratory parameters when changes in these parameters are averaged for patients with heart disease.
- The study 5 suggests that benzodiazepines may be used as add-on antihypertensive in a subset of patients in the short term, but more clinical trials and mechanistic research are required to ascertain the long-term benefits.
- The study 6 discusses the epidemiology, prognosis, and treatment of orthostatic hypotension, which can be a complication of hypertension treatment, but does not specifically address the effects of Valium on blood pressure.