Do Benzodiazepines Lower Blood Pressure? What to Know When Using Any Benzos

So – Do Benzodiazepines Lower Blood Pressure?

Benzodiazepine use on blood pressure depends on a few factors.

• If you’re older (60+ years), there’s a higher chance that benzodiazepines like Xanax may lead to a modest blood pressure drop. This effect is often more noticeable in older adults, especially those who may already have some level of hypertension.
• If you’re younger or generally healthy, the blood pressure-lowering effect of benzodiazepines is often unpredictable and likely minimal. It’s not something to count on as a treatment for high blood pressure.

Benzodiazepines are not a reliable or safe solution for managing blood pressure, especially if you have cardiovascular issues or are in recovery. They are not intended for hypertension control.

Always consult a healthcare professional for proper treatment of high blood pressure.

Mechanisms: Why Might Benzodiazepines Lower BP?

Benzodiazepines like Xanax can lower blood pressure through several mechanisms. 

Here’s how they might work:

• Impacting nervous system activity: Benzodiazepines reduce sympathetic nervous system activity, lowering the “fight or flight” response, heart rate, and blood vessel constriction, which may help lower blood pressure.
• Direct vasodilatory and muscle-relaxant properties: Some benzodiazepines have been studied for their vasodilatory effects, meaning they can help relax and widen blood vessels, which can also contribute to lowering blood pressure (OUP Academic).
• Anxiety reduction: Anxiety is a common cause of elevated blood pressure, so by reducing anxiety, benzodiazepines indirectly help lower blood pressure.
• Age-related pharmacokinetic changes: Older adults often experience slower metabolism and clearance of benzodiazepines, leading to higher drug levels in the body. This increased effect can result in a greater blood pressure drop, especially in older individuals.

What This Means for Recovery & Health (Especially in Context of Addiction)

While benzodiazepines can help reduce anxiety and lower blood pressure in some cases, their use can pose risks, especially in recovery. Understanding these effects is crucial for those managing hypertension or recovering from substance use disorders, as relying on benzodiazepines can lead to potential complications.

Why People in Rehab or Recovery Should Care

• If someone uses benzodiazepines (legally or misused), their BP and cardiovascular health are factors: anxiety, withdrawal, and co-occurring disorders can all impact BP.
• During benzo use, the mild BP lowering might mask other risks; during withdrawal, BP might rebound/hyper-react.

Practical Tips

• Monitor your blood pressure (and orthostatic BP: lying, sitting, standing)
• Inform your healthcare provider about benzo use (and dose/taper plans)
• Be cautious about standing up quickly if you feel dizzy or light-headed
• Avoid combining benzos with other BP-lowering or sedative drugs without close supervision
• Focus on general cardiovascular health: exercise, nutrition, stress/isolation reduction (which align with holistic recovery models)

When to Seek Professional Advice

If you’re using benzodiazepines and are concerned about their effects on your blood pressure, it’s important to know when to seek professional advice. 

Here are some key situations where consulting a healthcare provider is necessary:

• For individuals using benzodiazepines with a history of hypertension, heart disease, dizziness when standing, or a fall risk, it’s important to monitor for potential complications.
• Should you experience symptoms like light-headedness, fainting, accelerated heart rate, or blood pressure fluctuations during benzodiazepine use or tapering, consult a healthcare provider.
• When planning to discontinue benzodiazepines, be sure to discuss monitoring blood pressure changes and potential withdrawal effects with your doctor.
• If you’re using benzodiazepines alongside blood pressure medications, sedatives, or opioids, be aware of the increased risk of additive hypotension.

Frequently Asked Questions

Does stopping benzodiazepines cause blood pressure to go up?

Yes, withdrawal from benzodiazepines can lead to a phenomenon called sympathetic rebound, where the sympathetic nervous system becomes overactive, causing an increase in heart rate and blood pressure. Therefore, it’s important to carefully monitor blood pressure when discontinuing benzodiazepines, especially for individuals with pre-existing hypertension or cardiovascular concerns.

Can benzodiazepines be used as a treatment for hypertension?

No, benzodiazepines are not recommended for the treatment of hypertension. While benzodiazepines like Xanax may have a modest blood pressure-reducing effect in some cases, the risks of dependence, side effects, and misuse far outweigh any benefits. There is no clinical guideline supporting their use as a treatment for high blood pressure.

Are all benzodiazepines the same in this effect?

No, the effect of benzodiazepines on blood pressure in patients can vary depending on factors like half-life, dosage, age, and comorbidities. Although the evidence is not strong enough to say one benzodiazepine has a consistently stronger effect on blood pressure in patients, medications like Xanax may have different outcomes compared to others, especially in how they affect blood pressure in hypertensive patients.

What about younger people taking benzos — will their BP drop?

In younger individuals, the blood pressure-lowering effect of benzodiazepines is typically minimal and less consistent. Studies suggest that benzodiazepines have a more pronounced blood pressure effect in older adults, with minimal impact on those under 60 years old.

Conclusion

Benzodiazepines can sometimes lower blood pressure, particularly in older adults or with long-term use, but the effect is usually small and not a dependable way to manage blood pressure. For those in recovery or with a history of addiction, it’s important to be mindful of how benzodiazepines might affect your heart health. Taking care of your body is essential, and regularly checking in with a healthcare provider to monitor your blood pressure and overall well-being can help you stay on track toward better health and peace of mind. 

If you or someone you care about is using benzodiazepines and seeking recovery, Guiding Road Recovery Center is here to guide and support you through the process. Contact us today to learn how we can help you be on the path to a safer, healthier future.

Taking benzodiazepines like Xanax can be beneficial to relieve anxiety. However, if you have issues with blood pressure, it is important to consider the question “Do benzodiazepines lower blood pressure?“.

A 2023 meta-analysis of seven studies found that benzodiazepines can reduce both systolic and diastolic blood pressure in certain individuals for a short time, often due to their calming effects on anxiety.  However, benzodiazepines shouldn’t be relied upon as a treatment for high blood pressure (hypertension). 

This blog will cover what benzodiazepines are, how blood pressure works, when to seek professional advice, and much more, helping your loved ones struggling with benzodiazepines make informed decisions about treatment options and when to seek professional guidance.

Key Takeaway

• Benzodiazepines may lower blood pressure, but the effect is modest and unpredictable.
• Benzodiazepines are not a safe or reliable treatment for high blood pressure, especially for those with heart conditions or in recovery.
• Monitor blood pressure when using benzodiazepines, especially during withdrawal or with other BP-affecting meds, and consult a healthcare provider for safety.

What Are Benzodiazepines?

Benzodiazepines are a class of medications commonly prescribed to treat conditions such as anxiety, insomnia, muscle spasms, and seizures. Common examples of prescription drugs include Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam).

Common uses

Benzodiazepines work by depressing the central nervous system, reducing blood pressure in short term by providing relaxation to the brain functioning. However, they carry risks like drowsiness, memory issues, dizziness, dependence, and withdrawal symptoms. 

Long-term use can lead to cognitive impairment and a higher risk of depression. Benzodiazepines should only be used under medical supervision, particularly when combined with other medications or substances, to manage potential side effects and risks effectively.

How they work 

Benzodiazepines help calm the brain by boosting the effects of a chemical called GABA. Gamma-Aminobutyric Acid (GABA) is an inhibitory neurotransmitter in the brain that helps regulate nerve activity. When benzodiazepines attach to certain receptors in the brain (called GABA-A receptors), they allow more chloride ions to enter nerve cells, which makes them less likely to send signals. This makes the brain less active, helping you feel relaxed and calm. 

For some people, it can lead to a temporary calming effect of benzodiazepine in lowering blood pressure, especially in the short term. However, this doesn’t happen to everyone, and the effect can vary from person to person.

How Blood Pressure Works: A Brief Overview

By explaining what blood pressure is, this section provides a brief about how it’s measured, and what affects it. 

What Is Blood Pressure (Systolic/Diastolic)?

Blood pressure is the force of blood against artery walls as your heart pumps. Systolic pressure is the higher number, when your heart beats, and diastolic pressure is the lower number, when your heart rests. Lower diastolic and systolic blood pressure can be a sign of good health, but if too low, it may cause dizziness or fainting.

Role of Sympathetic vs Parasympathetic Nervous System

The sympathetic nervous system is the body’s “fight or flight” response, increasing heart rate and constricting blood vessels, which can raise blood pressure. In contrast, the parasympathetic nervous system helps your body “rest and digest,” slowing the heart rate and relaxing blood vessels, which can lower blood pressure.

What Regulates Blood Pressure?

Several factors influence blood pressure, including heart rate (how fast the heart beats), blood vessel tone (how wide or narrow the blood vessels are), and fluid volume (the amount of blood in circulation). Factors contributing to an increase in blood pressure include increased heart rate, narrowing of blood vessels, excess fluid volume, activation of the sympathetic nervous system due to stress or anxiety, obesity, high salt intake, hormonal changes, smoking, excessive alcohol consumption, and certain medications. 

Why Substances That Alter Nervous System Tone May Affect Blood Pressure?

Medications and substances that affect the nervous system, like benzodiazepines, can influence blood pressure by altering how the sympathetic and parasympathetic systems work. Due to its relaxing effects, it can potentially lead to a drop in blood pressure.

The Evidence of BP Reduction

Short-Term Studies

Research has shown that benzodiazepines can help reduce blood pressure in the short term, especially in hypertensive patients. A meta-analysis of seven studies found that benzodiazepines were comparable to standard antihypertensive drugs in reducing blood pressure, though the difference was not always statistically significant.

Long-Term/Older Adult Studies

In long-term studies, regular use of benzodiazepines in older adults (65+ years) has been linked to a modest reduction in systolic blood pressure, with a decrease of about 2.5 mmHg over time.

Study of ≥60 Y/O

A study of individuals aged 60 and above found that regular benzodiazepine consumption was associated with lower ambulatory blood pressure measurements, suggesting a potential benefit for blood pressure control in older adults.

Orthostatic Hypotension and Older Adults

However, benzodiazepine use in older adults can also come with risks. A study found that benzodiazepine users had lower baseline systolic blood pressure and experienced a greater drop in blood pressure when standing, which can increase the risk of falls, especially in older persons.

The Most Important Limits & Risks

While benzodiazepines can lower your blood pressure in some cases, especially in older adults, the effect is usually small and comes with some risks. It’s important to keep in mind that benzodiazepines should not be relied upon as a treatment for hypertension or high blood pressure.

• Benzodiazepines typically lower blood pressure by 1-3 mmHg, with a more noticeable effect in older adults, especially on systolic pressure. Younger individuals may not experience significant changes.
• Some studies, like a Belgian retrospective study, suggest that long-term use of short-acting benzodiazepines for conditions like insomnia may increase the risk of hypertension, challenging the idea that benzodiazepines consistently lower blood pressure.
• Orthostatic hypotension, which causes a sudden drop in blood pressure when standing, is a known side effect of benzodiazepines. This can lead to dizziness and an increased risk of falls, particularly in older adults who are more vulnerable to these effects.
• Benzodiazepines are not intended or approved for managing high blood pressure or hypertension. While they may reduce blood pressure temporarily, they should not be used as a primary treatment for blood pressure issues, and their use should be monitored closely by a healthcare professional.

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