What’s the Connection Between Asthma and High Blood Pressure?
July 27, 2023

What’s the Connection Between Asthma and High Blood Pressure?

Not only does the respiratory disorder increase your risk of hypertension, but drugs that treat one can worsen the other. Here’s how to stay safe.  

If you’ve been diagnosed with asthma of any type, you’ll be advised to follow certain steps to help manage it—for example, knowing and avoiding your triggers, taking your medication as directed, and implementing lifestyle habits like diet and exercise that can improve lung function. Here’s another one for that list that may be more surprising: Know your blood pressure numbers.

People with asthma are at higher risk of developing high blood pressure, also called hypertension, compared to those without asthma, says cardiologist Robert Segal, M.D., founder of Manhattan Cardiology in New York City.

Because hypertension often comes without symptoms, he says it’s essential for those with asthma to understand this risk and how managing asthma can help keep your blood pressure numbers down.

Confused about the connection? Follow along as our experts provide a deep dive into the link between these two conditions and how you can manage both effectively.

How Hypertension and Asthma Are Connected

The hypertension and asthma connection is considered bidirectional, which means having one can exacerbate the other and vice-versa. For instance, hypertension can make asthma attacks more frequent and severe, according to John Higgins, M.D., a cardiologist at UTHealth Houston in Texas. On the flip side, asthma itself can cause changes to the body that affect the entire cardiovascular system, including the blood vessels, leading to high blood pressure.

“Asthma is associated with inflammation throughout the body, and that affects not only the lungs but also the heart,” Dr. Higgins explains. In fact, between 50% and 70% of people with asthma have a certain type of hyper-inflammatory response called type 2 inflammation, according to the Allergy and Asthma Network, which puts their bodies in a state of chronic, systemic inflammation. This results in over-activation of immune cells that affect lung function as well as other body systems.

These prolonged high inflammation levels can also significantly raise heart disease risk, especially if asthma goes untreated and leads to asthma attacks. That’s a situation that can send blood pressure soaring, according to Dr. Segal.

“When a person has an asthma attack, their airways become narrow, making it harder for them to breathe,” he says. “This causes their body to release stress hormones, which can raise blood pressure. Additionally, if asthma is not well controlled, it can lead to chronic inflammation in the body, which can contribute to high blood pressure over time.”

How Do Blood Pressure Medications Affect Asthma?

Certain medications used to treat high blood pressure can exacerbate asthma, Dr. Segal says. A common treatment for hypertension is a class of drugs called beta blockers. These stop the action of the hormone epinephrine and subsequently slow your heart rate. While this can be beneficial for lowering blood pressure, it can have an unwelcome side effect for those with asthma.

“Beta blockers have the potential to make asthma symptoms worse by constricting the airways and making breathing more difficult,” Dr. Segal says. “However, other blood pressure drugs, such as ACE inhibitors and calcium channel blockers, are usually considered safe for persons with asthma and may even improve their lung function.”

How Do Asthma Meds Affect Blood Pressure?

Meanwhile, certain medications used to treat asthma can have a negative effect on blood pressure, Dr. Higgins says. For example, a class of drugs called beta-2 agonists are often prescribed for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) to help the airways relax and stay open (dilated). However, the drugs can increase heart rate and cause blood vessels to constrict, which can make blood pressure rise, he explains.

Corticosteroids, also frequently used to treat asthma, can result in sodium and water retention, which may elevate blood pressure as well, Dr. Higgins says.

Because of these potential effects, it’s crucial for people with both high blood pressure and asthma to speak with their doctor to ensure that they’re taking the right medications for each condition, without raising the risk of problems with the other condition.

Additionally, it’s helpful to put strategies in place to help you optimally manage each condition so that they don’t interfere with the other one. Let’s get to those now.

Tips for Managing Asthma

For asthma, Dr. Segal suggests these management tips:

  • Determine your personal asthma triggers, such as tobacco smoke, dust mites, pet dander, pollen, mold, and specific foods, and take steps to avoid them.
  • Engage in regular exercise, as recommended by your doctor.
  • Keep your living environment clean and free of dust and allergens.
  • Maintain a healthy lifestyle by eating a balanced diet, getting enough sleep, and managing stress.
  • Quit smoking and avoid secondhand smoke.
  • Take any prescribed medications as instructed by your doctor. These may include one or more daily medications for long-term symptom prevention as well as short-term relief drugs such as a rescue inhaler for asthma attacks.

“Together with your doctor, develop an asthma action plan,” Dr. Segal adds. “This plan explains the actions to take in certain circumstances, such as when to up the dosage of a medication or when to seek emergency medical attention.”

Tips for Managing High Blood Pressure

Dr. Higgins recommends these key steps for both managing high blood pressure (if you’ve already been diagnosed with hypertension) and reducing your risk of developing it:

  • Find healthy ways to cope with stress, such as practicing relaxation techniques, deep breathing exercises, or engaging in hobbies you enjoy.
  • Follow a healthy diet.Limit your intake of foods high in saturated fats, added sugar, and sodium, as well as avoiding processed and packaged foods.
  • Follow your doctor’s advice and take prescribed medications as directed.
  • If you drink alcohol, do so in moderation.
  • Limit your intake of caffeinated beverages like coffee, tea, and energy drinks. They can encourage extra urination, which can dehydrate your body; this in turn can increase your blood pressure, according to the Cleveland Clinic.
  • Monitor your blood pressure regularly using a home blood pressure monitor.
  • Stay hydrated and drink an adequate amount of water throughout the day.
  • Stay physically active. Consult your doctor before starting any new exercise regimen.
  • Quit smoking and avoid secondhand smoke.

As with asthma, controlling stress and getting quality sleep also are an important part of your blood pressure management plan, since both can have profound effects on hypertension, Dr. Higgins says.

Outlook for Both Conditions

Although it may sometimes feel overwhelming to manage both asthma and hypertension, there is plenty of overlap in terms of management strategies, says Dr. Segal. For example, lowering stress, quitting smoking, taking medications as directed, and exercising regularly can all go a long way toward improving blood pressure as well as helping keep your asthma well-controlled.

“If you have high blood pressure in addition to asthma, it’s important to carefully treat both conditions,” he says. “Working together with your healthcare provider is essential to create a unique treatment strategy that addresses both disorders while reducing any potential interactions or problems.”

Making sure that your medical specialists—such as your cardiologists and pulmonologist or allergist—are communicating about your treatment is also an important step, Dr. Higgins adds. “With all of these strategies put together, the prognosis is good for treating both conditions,” he says. That news should help you breathe a little easier.

Authored by: Elizabeth Millard