High blood pressure is a common condition that can quietly damage the heart, kidneys, eyes, and brain over time. That’s why many people take blood pressure medication daily to keep it under control. These medications are generally safe and have been used for decades.
But in recent years, scientists have started to look at how these drugs might affect another important part of the body — the gut. Your gut is home to trillions of bacteria, helps digest food, supports your immune system, and plays a big role in your overall health. So the question is: do blood pressure drugs raise the risk of gut problems?
The short answer is that some blood pressure drugs may be linked to a small increase in certain gut diseases, but the research is still ongoing and most people do not experience serious issues. Let’s break it down.
A few large studies have looked at whether certain types of blood pressure drugs are connected to gut diseases like celiac disease, inflammatory bowel disease (IBD), or microscopic colitis. One of the best-known studies was published in Gut, a medical journal, in 2020.
It found that people taking a type of blood pressure drug called olmesartan — which is part of the ARB (angiotensin receptor blocker) group — had a higher risk of developing a rare condition called sprue-like enteropathy.
This condition causes severe diarrhea, weight loss, and damage to the small intestine, similar to what happens in celiac disease. The symptoms often go away after stopping the drug. However, this side effect seems to be rare and has not been reported with other ARBs like losartan or candesartan.
Other studies have looked at the risk of microscopic colitis, a form of inflammation in the colon that causes chronic watery diarrhea. A 2021 study published in Alimentary Pharmacology & Therapeutics found that people taking certain blood pressure drugs, including beta-blockers, ACE inhibitors, and ARBs, had a slightly higher chance of developing this condition.
The risk was still low, and more research is needed to confirm how strong this link is. Most people taking these medications never develop gut inflammation.
Some researchers are also exploring how blood pressure medications affect the gut microbiome — the community of bacteria living in your digestive system. The gut microbiome helps digest food and supports the immune system. A few early studies suggest that some blood pressure medications may change the balance of gut bacteria.
For example, diuretics and ACE inhibitors might reduce bacterial diversity, while ARBs may increase certain helpful bacteria. These changes could affect digestion, metabolism, or inflammation levels in the body, but scientists are still learning what this means for long-term health.
It’s important to remember that high blood pressure itself can be harmful to the gut and other organs. Poor blood flow due to uncontrolled blood pressure can damage the lining of the stomach and intestines over time. So even if there are some risks with medication, the benefits of treating high blood pressure usually outweigh them.
In summary, most blood pressure medications are safe for the gut, but a few types, such as olmesartan, have been linked to rare digestive problems. If you’re taking blood pressure medicine and notice gut symptoms like ongoing diarrhea or stomach pain, it’s a good idea to talk to your doctor.
They may switch you to a different medication if needed. Don’t stop taking your medicine without medical advice — keeping your blood pressure under control is still one of the best things you can do for your overall health, including your gut.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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