Inhaler does not raise blood pressure

Published 3:55 am Friday, April 20, 2018

DEAR DR. ROACH: I am wondering if there is a safer inhaler to use in place of an al-buterol inhaler. I have high blood pressure that, at times, is very difficult to control. I have not yet tried the al-buterol inhaler. I was prepared to, but stopped before doing so after reading the side effects and potential dangers to the heart for someone with high blood pressure. — Anon.

ANSWER: Asthma is a condition of reversible airway obstruction. It has many triggers, such as smoke or other airborne irritants. Exercise, infection, cold air and emotional stress also can trigger an asthma attack, and in some people, attacks can happen for no clear reason.

Once an attack occurs, treatment with a fast-acting inhaler like al-buterol provides relief for most people, and it can even be lifesaving in people with very severe asthma. I recommend that all people with asthma have a fast-acting inhaler just in case. During an attack, the benefit outweighs the negligible risk to the heart.

However, it’s not optimal to take medicines like al-buterol all the time. They do raise the heart rate, causing palpitations and tremor. Albuterol usually does not raise blood pressure significantly.

People who use a lot of albuterol or similar inhalers are more likely to be hospitalized for asthma than those who don’t. To some extent, this is due to having more severe illness.