Many patients said that they did not have high blood pressure before, but after the detection of tuberculosis, their blood pressure became high, and the medication did not help! There are also patients who say that their blood pressure rises every time they take anti-tuberculosis drugs! There are also patients who say that they have had high blood pressure for many years and have been taking medication to control it well, but after they got tuberculosis, the medication didn’t work either, and their blood pressure went up and down like a roller coaster! Why is this so? The two diseases encountered together how like a wild horse out of control unruly it? 1, tuberculosis will cause high blood pressure? Studies have shown that general tuberculosis, bone tuberculosis, etc. will not cause high blood pressure, while kidney disease, including renal tuberculosis and hypertension may have a certain relationship! There is a concept here: hypertensive nephropathy and renal hypertension. The former is hypertension first, which causes structural damage to the kidneys and eventually leads to renal failure. The latter is hypertension that is secondary to kidney pathology, and hypertension caused by renal tuberculosis is one of them. When one has renal tuberculosis but does not produce clinical symptoms and heals without knowing it due to increased body resistance, this is called pathologic renal tuberculosis. If the condition continues to worsen, it may cause more serious hypertension. However, renal tuberculosis and hypertension may also exist independently and simultaneously without any relationship between the two. Therefore, renal tuberculosis and hypertension should be treated separately at this time. In recent years, some authors have pointed out that tuberculosis infection may be one of the important causes of hypertension, however, it has not been confirmed and widely recognized.2. Will blood pressure rise after taking anti-tuberculosis drugs? Currently, first-line anti-tuberculosis drugs include: isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin. It is usually believed that commonly used anti-tuberculosis drugs themselves do not cause an increase in blood pressure. However, some authors have observed that a small number of patients with tuberculosis who were not originally hypertensive experienced an increase in blood pressure during the application of rifampicin-type drugs (including rifamycin, rifapentine), which returned to normal after discontinuing these drugs, which is associated with sympathetic excitation. In hypertensive patients treated with antihypertensive drugs, the combined use of antituberculosis drugs can enhance the degradation of antihypertensive drugs and antihypertensive biologically active substances in the body by the liver, which reduces or even invalidates their effectiveness, leading to poor blood pressure control and increased blood pressure fluctuations. The most obvious effect is rifampicin. Rifampicin is a strong inducer of hepatic enzymes, and the combination of rifampicin and nifedipine has led to more reports of sharp increases in blood pressure that were already stable. When encountering such a situation, try to avoid the use of calcium antagonists, especially nifedipine. If it is necessary to apply, the dose should be increased according to the blood pressure, or switch to rifabutin, which has the weakest hepatic enzyme-inducing effect. In addition, after taking anti-tuberculosis drugs for a period of time, it is easy to have liver and kidney function damage, and it is easy to raise blood pressure when taking hepatoprotective and enzyme-reducing drug diammonium glycyrrhizinate, so it is recommended to give thiopronin and reduced glutathione to restore liver function and protect hepatocytes.3. What are the side effects when taking anti-tuberculosis drugs? How can they be minimized? Isoniazid is a hepatic enzyme inhibitor, which can slow down the metabolism of some drugs, so it is necessary to reduce the dosage of drugs, which can also cause liver function abnormalities, peripheral neuritis (abnormal sensation of the limbs), cause psychiatric symptoms, and induce epilepsy, etc.; Rifampicin is a hepatic enzyme inducer, so it is necessary to increase the dosage of the relevant drugs, which can also cause abnormalities of liver function, and allergic reactions (rash, flu-like symptoms); Streptomycin can cause Streptomycin can cause kidney and cranial nerve damage, can cause dizziness, tinnitus, hearing loss or even deafness, numbness of lips and mouth and other side effects; pyrazinamide in addition to liver damage, can also cause elevated blood uric acid leading to gout, try not to be used in conjunction with the dehydration drugs such as tachypnoea; ethambutol can cause retrobulbar optic neuritis leading to blurred vision. Anti-tuberculosis drug resistance has become a world problem, refractory, drug-resistant tuberculosis patients increased significantly. Therefore, the use of anti-tuberculosis drugs should follow the eight-pronged policy of “early, combined, adequate, and complete”, and there are now standardized chemotherapy and short-course chemotherapy, so please go to the hospital for details. Patients should be closely monitored for any side effects that may be related to the drugs mentioned above, and at the same time, attention should be paid to the protection of liver and kidney functions.