From the Guidelines
Cortisone injections can increase blood pressure, and patients should be closely monitored for this potential side effect, particularly those with pre-existing hypertension or cardiovascular disease. This is because corticosteroids, such as those used in cortisone injections, can promote sodium retention and fluid accumulation in the body, leading to increased blood volume and blood pressure 1. The American Society of Hematology 2019 guidelines for immune thrombocytopenia emphasize the importance of monitoring patients for potential corticosteroid side effects, including hypertension 1.
When considering the use of cortisone injections, it is essential to weigh the potential benefits against the risks, including the impact on blood pressure. The EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis suggest using the lowest dose of corticosteroids possible to minimize cardiovascular risk 1.
Key considerations for patients receiving cortisone injections include:
- Monitoring blood pressure closely, especially in the first few days after injection
- Informing healthcare providers about pre-existing hypertension or cardiovascular disease
- Potential adjustments to antihypertensive medications during the treatment period
- Using localized cortisone injections, which may have less impact on blood pressure than oral cortisone medications or injections given into muscle tissue.
Overall, the use of cortisone injections requires careful consideration of the potential risks and benefits, particularly with regards to blood pressure, and close monitoring to minimize adverse effects 1.
From the FDA Drug Label
Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. Average and large doses of corticosteroids can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium
Cortisone injections can cause an increase in blood pressure due to salt and water retention.
- Dietary salt restriction and potassium supplementation may be necessary to mitigate these effects.
- The risk of elevated blood pressure is more likely to occur with average and large doses of corticosteroids, including cortisone 2, 2, and 3.
From the Research
Cortisone Injections and Blood Pressure
- The relationship between cortisone injections and increased blood pressure is not directly addressed in the provided studies, but some studies touch on the systemic effects of glucocorticoids, which may include changes in blood pressure.
- A study on systemic absorption and side effects of locally injected glucocorticoids found that these injections can have systemic effects, including hyperglycemia, but does not specifically mention blood pressure 4.
- Another study discusses glucocorticoid-induced hypertension, suggesting that it is a common clinical problem, but the provided text does not offer specific insights into the effects of cortisone injections on blood pressure 5.
- The other studies focus on the effects of corticosteroid injections on blood glucose levels in diabetic patients 6, the use of antihypertensive drugs in daily life practice 7, and the precautions and cautions to be taken when using injectable corticosteroids 8.
- Overall, while there is some relevant information on the systemic effects of glucocorticoids, there is no direct evidence in the provided studies to fully answer the question about the relationship between cortisone injections and increased blood pressure.