Rationale Azelastine is commonly used for allergic rhinitis and vasomotor rhinitis. To our knowledge, there is no published case report that azelastine nasal spray aggravates hypertension. We report a case of elevated blood pressure due to azelastine in a previously controlled hypertensive patient.
Methods A 48-year-old African American woman seeking treatment for allergic rhinitis and with a history of hypertension presented at the Louisiana State University Health and Sciences Center Allergy and Immunology Clinic. She had tried many medications and only azelastine nasal spray relieved her nasal symptoms completely; however, azelastine caused an increase in her blood pressure. We measured the patient's blood pressure 10 minutes after using 1 spray of azelastine in each nostril. Her blood pressure went up from 134/86 mm Hg to 138/98 mm Hg. Then we arranged for the patient to be tested in our clinic with and without azelastine.
Results The blood pressure measurements at 2, 3, 5, and 6 minutes after the use of 2 sprays of azelastine in each nostril were 138/96, 138/96, 132/90, and 136/92 mm Hg, respectively. The baseline measurements at similar time points without azelastine use were 126/80, 112/80, 114/82, and 114/84 mm Hg, respectively. The test results revealed that the use of azelastine resulted in the elevation of her blood pressure.
Conclusions Azelastine nasal spray may increase both systolic and diastolic blood pressures. This information may be particularly useful for patients who have both hypertension and chronic rhinitis.