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language, randomized placebo-controlled trials of oral pseudoephedrine treatment in adults. The primary data extracted were systolic BP (SBP), diastolic BP (DBP), and HR. Study quality was as-sessed using the methods of Jadad, and data were synthesized using a random-effects model and weighted mean differences. Twenty-four trials had extractable vital sign information (45 treat-ment arms; 1285 patients). Pseudoephedrine caused a small but significant increase in SBP (0.99, mm Hg; 95 % CI, 0.08 to 1.90) and HR (2.83 beats/min; 95 % CI, 2.0 to 3.6), with no effect on DBP (0.63 mm Hg, 95 % CI, –0.10 to 1.35). The effect in patients with controlled hypertension dem-onstrated an SBP increase of similar magnitude (1.20mmHg; 95%CI, 0.56 to 1.84mmHg). Higher doses and immediate-release preparations were associated with greater BP increases. Studies with more women had less effect on BP or HR. Shorter duration of use was associated with greater in-creases in SBP andDBP. Arch InternMed. 2005;165:1686-1694 Oral pseudoephedrine is a common in-gredient in more than 135 over-the-counter and prescription medications.1,2 Brands of common over-the-counter and prescription decongestants that contain pseudoephedrine include Allegra-D, Alka