Doctors in Canada are reporting an unusual case of hypertensive emergency induced by liquorice tea in an 84-year-old man and say the case highlights the importance of questioning patients on intake of liquorice-containing products when they present with de novo hypertension, exacerbated hypertension or hypertensive crisis.
The patient presented to an emergency department with a hypertensive emergency, reporting a one week history of persistently elevated home systolic blood pressure measurements (180-210 mmHg), along with symptoms of headache, photophobia, chest pain and fatigue. On presentation, his blood pressure was 196/66 mmHg. While the patient had long-standing hypertension, a blood pressure measurement taken four months earlier showed adequate control (125/60 mmHg). Plasma renin activity and serum aldosterone were suppressed, with doctors diagnosing pseudohyperaldosteronism.
After admission and treatment, the patient told physicians he had been drinking one to two glasses daily of homemade liquorice root extract called 'erk sous' for two weeks. While he knew there was a potential association between liquorice consumption and high blood pressure, he did not think of it when he noticed his blood pressure starting to rise.
Presenting the findings in the Canadian Medical Association Journal, the authors said the findings highlight the importance of educating patients with hypertension about the potential adverse effects of liquorice.