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February 21, 2017

High Blood Pressure Medication Helps with Nasal Polyps!

Verapamil, a blood pressure medication, may help with an uncommon disorder called nasal polyps that afflict certain individuals causing significant nasal congestion, nasal obstruction, smell loss, and chronic sinusitis. Nasal polyps appear like a cluster of grapes within the nasal and sinus passages leading to subjective sino-nasal symptoms.

Although sinus surgery can physically remove the nasal polyps, whatever trigger caused their initial formation can lead to their regrowth. As such, medical management is required along with surgical treatment for long-term control.

Such medical treatment to try and prevent nasal polyp recurrence or growth include:

Allergy control with immunotherapy if applicable (i.e., allergy shots)
• Leukotriene inhibitor medications (i.e., Singulair, xolaire, etc)
Steroid nasal sprays
• Systemic steroids (i.e., prednisone)

Depending on other medical morbidities that may be present, additional treatment with monoclonal antibodies (i.e., nucala) may be required.

However, Harvard researchers have published that verapamil may be very helpful to add to the medical management for nasal polyp control.

The research conducted was a double-blind, placebo-controlled, randomized clinical trial. Verapamil's beneficial affects on controlling symptoms of nasal polyps is due to its inhibitory effect on P-glycoprotein, a protein pump found in the nasal lining and over-expressed in patients with nasal polyps leading to hyper-secretion of inflammatory chemicals. By suppressing P-glycoprotein with verapamil, the overall burden of inflammatory chemicals in the nose could be decreased resulting in improved symptoms.

More research is needed to see if this hypertension medication provides true, effective, long-term benefit... BUT... if a patient with nasal polyps also has high blood pressure, it may be worthwhile to take verapamil preferably over other kinds of blood pressure medications to help with both blood pressure AND hypothetically nasal polyps too!


References:
Double-blind placebo-controlled randomized clinical trial of verapamil for chronic rhinosinusitis with nasal polyps. J Allergy Clin Immunol. 2017 Jan 11. pii: S0091-6749(16)31444-0. doi: 10.1016/j.jaci.2016.11.014. [Epub ahead of print]

Secreted P-glycoprotein is a noninvasive biomarker of chronic rhinosinusitis. Laryngoscope. 2017 Jan;127(1):E1-E4. doi: 10.1002/lary.26249. Epub 2016 Aug 31.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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