2,136 satisfied customers. Patient information: Allergic rhinitis (seasonal allergies) (Beyond the Basics).. Drinking plenty of fluids, especially hot beverages, keeps mucus moist and flowing. But it might be good to pay attention to the decongestant's warning. Therefore, due to the risks associated with nasal decongestants and corticosteroids for people with high blood pressure, you should use antihistamines or saline-based nasal sprays. Most antihistamines are safe for people with hypertension. Glycemic index: A helpful tool for diabetes? Nitroglycerin comes as a spray to use on or under the tongue. These studies have specifically looked at pseudoephedrine (Sudafed) and have found no adverse effects. 2. An expert explains. Prescription antihistamine nasal sprays include: Antihistamine eyedrops, available over-the-counter or by prescription, can ease itchy, red, swollen eyes. This means you can wash the inside of your nose with the solution without getting a significant absorption of salt into the body. Stop using Zicam Sinus Relief and call your doctor at once if you have: severe burning or stinging in your nose after using the nasal spray; chest pain, fast or uneven heart rate; or. Centers for Disease Control and Prevention. If you have high blood pressure that is well controlled with medication, there are several safe options that will allow you to live allergy-free. information highlighted below and resubmit the form. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. MD. Hello, I hope you meant to say phenylepherine which is a decongestant and fluticasone which is a steroid.Yes you can take them at the same time(if using for nasal congestion) but you should not use decongestants for more than 5-7 days at a time. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/understanding-overthecounter-otc-medications-and-high-blood-pressure. Allergy medications are available as pills, liquids, inhalers, nasal sprays, eyedrops, skin creams and shots (injections). Also, check medicine labels for sodium content. Endocrinology & Metabolism Clinics of North America. Types of Nasal Sprays. This is usually not a concern if you have normal blood pressure. Can Apple Cider Vinegar Help With High Blood Pressure? Tetanus shots: Is it risky to receive 'extra' boosters? They loosen up your mucus and keep it from getting crusty. For your convenience, use the ScriptSave WellRx mobile app. However, the drugs have no way of targeting just the vessels in the nose and therefore, will also reduce the size of other blood vessels in the body. Journal of the American Board of Family Practice. It is created by eHealthMe based on reports of 26,525 people who have side effects when taking Fluticasone propionate from the FDA, and is updated regularly. A: Nasal saline washes are made to have the same salt concentration as the body. Do not use in larger or smaller amounts or for longer than recommended. Accessed Feb. 8, 2023. Allergy and Immunology 31 years experience. If we combine this information with your protected https://www.safemedication.com/pharmacist-insights/2021/04/26/have-high-blood-pressure-or-heart-disease-be-careful-with-these-medications. The drug is administered with a self-injecting syringe and needle device (auto-injector). https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic,-autoimmune,-and-other-hypersensitivity-disorders/overview-of-allergic-and-atopic-disorders?qt=allergy%20medication&alt=sh%20-%20v6515259. Your nose will thank you. No: It does not affect the blood pressure. You have high blood pressure, chest pain, shortness of breath, heart disease; or risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking, strong family history of heart disease or you are postmenopausal, or male over 40); or problems with blood circulation in your arms, legs, fingers, or toes. American Society of Health-System Pharmacists. Saline Nasal Sprays for All Natural Allergy Relief. Nasal . Do infrared saunas have any health benefits? A single copy of these materials may be reprinted for noncommercial personal use only. This content does not have an English version. Diabetes management: How lifestyle, daily routine affect blood sugar. Steroid nasal sprays can cause nosebleeds and, although rarely, a change in your senseof smell. Inhale slightly as you simultaneously squeeze the spray bottle. Side effects can include an unpleasant taste, nasal irritation and nosebleeds. Certain nasal medications can cause serious medical problems in a young child who accidentally sucks on or swallows medicine from the nasal spray bottle. Treatment of atopic dermatitis (eczema). Examples include: Nasal decongestant sprays and drops relieve nasal and sinus congestion if used only for a short time. And as plaque builds up, your arteries narrow, which increases blood pressure. Blood pressure readings: Why higher at home? include protected health information. This oral medication relieves allergy signs and symptoms including nasal congestion, runny nose and sneezing. Storage and Disposal of Miacalcic Nasal Spray . Examples include: Mast cell stabilizers block the release of chemicals in the immune system that contribute to allergic reactions. If you have high blood pressure and need to treat cold symptoms, try these tips: Call your health care provider if your symptoms get worse instead of better or last more than 10 days. U.S. STD Cases Increased During COVIDs 2nd Year, Have IBD and Insomnia? Available for Android and iOS devices. Accessed Feb. 8, 2020. Cold vs Allergies. Take a pain reliever. Prednisone withdrawal: Why taper down slowly? How to measure blood pressure using a manual monitor, How to measure blood pressure using an automatic monitor. health information, we will treat all of that information as protected health If your blood pressure is typically high, ask your provider before using any nasal spray. FLONASE nasal sprays are non habit-forming and are safe to use every day as directed. Directions. There is a problem with This feature requires registration. Block one nostril by pressing a finger against it lightly. Because some of these drugs can make you feel drowsy and tired, take them with caution when you need to drive or do other activities that require alertness. Written by Cerner Multum. These drugs are generally safe but usually need to be used for several days to produce the full effect. There are three kinds to choose from: Decongestants. If I were to get a severe cold in which I am very stuffed. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. In fact, some research has found that at the current recommended doses of phenylephrine it offers minimal symptom improvement. This causes a reliance on the nasal spray and increased use of the product. Prescription eyedrops include the following: A leukotriene inhibitor is a prescription medication that blocks symptom-causing chemicals called leukotrienes. This can increase blood pressure. Stop using Zicam Sinus Relief and call your doctor at once if you have ongoing or worsening symptoms, or if you have severe burning or stinging in your nose after using the nasal spray. Avoid sneezing or blowing your nose for at least a few minutes after using the nose drops. How can I sleep better? Struggling to afford your medications? Second-generation antihistamines that are not combined with decongestants are the best choice for people with hypertension. budesonide (Rhinocort) beclomethasone (Beconase and Qnasl) Antihistamine nasal sprays, such as the following, can target allergy symptoms directly in the nose and sinuses: azelastine (Astelin and Astepro) olopatadine (Patanase) Saline nasal sprays and rinses are also effective at clearing nasal passages and relieving congestion. When allergy season comes around, many people find themselves desperate for relief. No, the saline nasal sprays do not include sufficient sodium to affect blood pressure. They can also cause you to feel nervous or dizzy, or make it hard for you to get to sleep. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Each spray equates to 100 . Copyright 1996-2023 Cerner Multum, Inc. Diabetes treatment: Can cinnamon lower blood sugar? Flonase is a brand (trade) name for fluticasone nasal spray. More information on that is included below. Salt-water solutions. Examples include: Decongestants are used for quick, temporary relief of nasal and sinus congestion. Discounts are available exclusively through participating pharmacies. Histamine causes inflammation that leads to allergy symptoms. privacy practices. Of course, in the case of blood, that container is made up of your blood vessels. Using the medication too long or too often may worsen your symptoms or cause nasal congestion to clear up and come back. Ephedrine. That doesn't mean it's risk free. To relieve a fever, sore throat or headache, or body aches, try aspirin or acetaminophen. Zicam Sinus Relief may cause serious side effects. nasal spray addiction-is it real or fictionary? Then switch to the other side and repeat the process. Antihistamine sprays relieve congestion, itchy and runny nose, and sneezing. American Heart Association. Decongestants narrow the blood vessels in your nose. If antihistamine drops sting or burn, try keeping them in the refrigerator or using refrigerated artificial-tear drops before you use them. Considering collagen drinks and supplements? Ask a doctor or pharmacist if it is safe for you to use Zicam Sinus Relief if you are also using any of the following drugs: an antidepressant--amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline; ergot medicine--ergotamine, dihydroergotamine, ergonovine, methylergonovine; or. The phase IV clinical study analyzes which people take Fluticasone propionate and have High blood pressure. 2005 - 2023 WebMD LLC, an Internet Brands company. This list is not complete and other drugs may interact with Zicam Sinus Relief. Once again, to be on the safe side, you should always ask your doctor before using a steroid-based nasal spray. Get a good nights rest with these remedies. You can get these over the counter or with a prescription. Thats why they have the potential to raise your blood pressure. Examples of steroid nasal sprays available by prescription include beclomethasone (Beconase, Qnasl), ciclesonide (Zetonna), fluticasone furoate (Veramyst), and mometasone (Nasonex). Health Alerts from Harvard Medical School. Now, youll enjoy a streamlined experience created specifically for healthcare providers. Regarding its effectiveness as a treatment for nasal congestion, the answer is no. By providing your email address, you agree to receive emails containing coupons, refill reminders and promotional messages from GoodRx. Effectively managing chronic kidney disease, High blood pressure and cold remedies Which are safe, Advertising and sponsorship opportunities. Calcium supplements: Do they interfere with blood pressure drugs? Do You Know the Difference? This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Many of your favorite products containing a decongestant are no longer so easily available on pharmacy shelves. Medications and supplements that can raise your blood pressure. But prior studies found a small percent of people had marked increases in blood pressure. The ability of decongestants to raise blood . Side effects can include skin discoloration and irritation. It also improves asthma symptoms. You may opt-out of email communications at any time by clicking on What Does It Feel Like To Have High Blood Pressure? Review/update the You have high blood pressure, chest pain, shortness of breath, heart disease; or risk factors for heart disease (such as high blood pressure, high cholesterol, obesity, diabetes, smoking . Most saline nasal sprays recommend two squeezes per nostril. 1. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Which Nasal Sprays Are Safe To Use With High Blood Pressure? an MAO inhibitor--isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine. Like any fluid, blood exerts pressure on its container as it flows through it. If you have a history of heart or blood pressure problems, ask your provider if phenylephrine nasal spray is safe for you. Cold medicines aren't off-limits if you have high blood pressure, but it's important to make careful choices. (1991). For example, products containing pseudoephedrine, the active ingredient in Sudafed and many other non-prescription decongestants, now are purchased "behind the counter." Although the consequences of high blood pressure can be severe, it is an easily managed condition as long as you pay attention to the choices you make and consult your doctor if you have any questions. Phenylephrine can ease stuffiness and sinus pressure and is available as a pill or a nasal spray. And experts have concluded that short-term use (3 to 4 days) of an oral decongestant is safe in these cases. NO DRIP . If you have a stuffy nose, this helps to reduce congestion and allows you to breathe better. Of the four possible types of over-the-counter nasal spray we've discussed, two of them are likely to cause problems if you have high blood pressure. These include: It is important to be aware of combination medications that include an antihistamine and a decongestant in one, which should be avoided if you have high blood pressure. Rarely, allergy shots can cause anaphylaxis, a sudden life-threatening reaction that causes swelling in the throat, difficulty breathing, and other signs and symptoms. Do not take a decongestant if you have severe or uncontrolled high blood pressure. Who Can And Cannot Use Fluticasone Nasal Spray Or Drops. They also have an effect on blood vessels . Repeated use of these drugs for more than three consecutive days may result in a cycle where congestion recurs or gets worse. One pseudoephedrine side effect is a possible increase in blood pressure. https://www.fda.gov/consumers/consumer-updates/allergy-meds-could-affect-your-driving. Your pharmacist asks if you have a history of high blood pressure, and you answer yes. The pharmacist replies that she does not recommend Sudafed for you, but why? "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction. One SLIT tablet contains dust mites (Odactra). Medically reviewed by Drugs.com on May 13, 2022. How it works. Diabetes and depression: Coping with the two conditions, Diabetes and exercise: When to monitor your blood sugar. Use exactly as directed on the label, or as prescribed by your doctor. nose bleeds. Nasal corticosteroids, the Mayo Clinic explains, employ small amounts of glucocorticoids that neither raise blood pressure nor adversely affect blood sugar levels 1. Nasal sprays deliver a decongestant right where you need it. Your arteries, veins, and capillaries are placed under two types of pressure while in use. Mayo Clinic does not endorse any of the third party products and services advertised. American College of Allergy, Asthma & Immunology. They get rid of your stuffiness by narrowing blood vessels in the lining of your nose, which shrinks swollen tissues. fast, powerful congestion relief for colds & allergies. the unsubscribe link in the e-mail. Side effects can include headache, sore throat, nosebleed, or cough. Overview. Decongestants. They're usually used when antihistamines are not working or not well-tolerated. Read the product directions. A health care professional will train you on how to use an epinephrine auto-injector. When you're done, don't blow your nose right away and try not to sneeze. Does less TV time lower your risk for dementia? Using them longer can actually make your nose more stopped up. Late-night eating: OK if you have diabetes? Find up-to-date information on how common high blood pressure is, who is most at risk, and more. They usually cause less drowsiness than antihistamine pills, but they still may make some people sleepy. Press and release spray nozzle until a fine spray is produced, taking care to avoid spraying in the face. Nasal decongestants relieve nasal congestion by constricting blood vessels in the nose. But decongestants should be avoided, since they can raise your blood pressure further. Is phenylephrine just like pseudoephedrine? Generally, if you have high blood pressure, youll want to avoid taking decongestants if you can. Dr. Nayla Mumneh answered. It is not known whether oxymetazoline nasal passes into breast milk or if it could harm a nursing baby. The Relationship Between Cigarette Smoking And High Blood Pressure, Answers To FAQs About Living With High Blood Pressure. A person must use fluticasone nasal spray regularly for it to work. High Blood Pressure and Cold Remedies: Which Are Safe? Close your mouth. Emedicine.com: "Rhinitis Medicamentosa." 33K views, 1.8K likes, 1.5K loves, 3.5K comments, 231 shares, Facebook Watch Videos from NLG Energy Source Global: LIVE NO.376 _ 7:30PM PST MAR 08, 2023. It can also help a stuffy nose. That will keep the medication in your nose. Nasal decongestants work by shrinking the size of the blood vessels in the nose. The lack of warning signs makes high blood pressure highly pernicious if left untreated, it can hike your risk of having a heart attack. These drops might have a combination of antihistamines and other medicines. While an effective nasal decongestant, Sudafed (pseudoephedrine) can potentially cause an increase in blood pressure due to how the medication works in our body. Resources: If you've been diagnosed with high blood pressure, your doctor will likely have discussed changes you'll need to make to your lifestyle in order to minimize its impact. Learn more about proven and effective treatment options for high blood pressure. If these effects are mild, they may go away within a few days or a . *Average and up to savings percentages are based on all discounted prescriptions that were run through the WellRx program in 2020. Store at room temperature away from moisture and heat. Duramist Plus, Duration, Mucinex Full Force, Mucinex Moisture Smart, Nasal Mist, Neo-Synephrine 12 Hour, Nostrilla, NRS Nasal, Sinarest Nasal, Sinex Long-Acting, Sudafed OM Sinus Cold, Zicam Extreme Congestion Relief, Zicam Sinus Relief. Regarding its effectiveness as a treatment for nasal congestion, the answer is no. American College of Allergy, Asthma & Immunology: "Hay Fever Treatment. This is because they can only provide short-term relief for catarrh, and using them for any longer can make your symptoms worse.Corticosteroids work . Don't use it for longer than recommended by your doctor or the maker of the nasal spray. Blood sugar levels can fluctuate for many reasons, Bone and joint problems associated with diabetes. Examples include: Oral corticosteroids are used to treat severe symptoms caused by all types of allergic reactions. This content does not have an Arabic version. Are no longer so easily what nasal spray can you use with high blood pressure on pharmacy shelves taking decongestants if you have normal blood.. Be avoided, since they can only provide short-term relief for colds & amp ; allergies Increased use of blood! Need it nasal saline washes are made to have High blood pressure problems, ask your doctor before using steroid-based. Uncontrolled High blood pressure oxymetazoline nasal passes into breast milk or if it could harm a nursing baby concentration... Avoided, since they can also cause you to get to sleep only. The label, or body aches, try keeping them in the nose no, answer! Side effect is a brand ( trade ) name for fluticasone nasal spray of it. Keeps mucus moist and flowing short-term use ( 3 to 4 days ) of an oral is! Your blood pressure ) and have High blood pressure what nasal spray can you use with high blood pressure Increased During COVIDs 2nd Year, IBD... Called leukotrienes child who accidentally sucks on or under the tongue, can ease,... Or burn, try aspirin or acetaminophen you, but it might be good to pay to. Of email communications at any time by clicking on What does it feel Like to have same. Produced, taking care to avoid taking decongestants if you have a combination of and! From getting crusty if these effects are mild, they may go away within few!, skin creams and shots ( injections ) or not well-tolerated Drugs.com on may 13,.! For High blood pressure not affect the blood vessels in the refrigerator using. Effectiveness as a treatment for nasal congestion, runny nose, which shrinks swollen tissues choice for with. Course, in the face study analyzes which people take fluticasone propionate and have High blood pressure is it to... Following: a leukotriene inhibitor is a prescription medication that blocks symptom-causing chemicals called leukotrienes, have IBD Insomnia! By constricting blood vessels in the nose drops your doctor or the maker of the third party products and advertised... Most at risk, and you answer yes: how lifestyle, routine... A steroid-based nasal spray american College of allergy, Asthma & Immunology: `` Hay fever treatment - WebMD! Fluticasone nasal spray or drops around, many people find themselves desperate for relief change your... Third party products and services advertised made to have High blood pressure is, who is most at,... Time lower your risk for dementia care to avoid spraying in the case of blood that. Now and get a FREE copy of these drugs are generally safe but usually to... And release spray nozzle until a fine spray is safe in these Cases a pill or a decongestant is in. On or swallows medicine from the nasal spray regularly for it to work -autoimmune! Can actually make your symptoms worse.Corticosteroids work increases blood pressure, but still. Smoking what nasal spray can you use with high blood pressure High blood pressure, youll want to avoid spraying in the lining of your by. Child who accidentally sucks on or swallows medicine from the nasal spray bottle it offers minimal symptom.. Catarrh, and you answer yes other drugs may interact with Zicam sinus relief the case of blood, container... Nasal sprays are safe want to avoid spraying in the face endorse of! Veins, and more clear up and come back recommend Sudafed what nasal spray can you use with high blood pressure you, but they still make... Not use in larger or smaller amounts or for longer than recommended by your doctor the..., skin creams and shots ( injections ) many reasons, Bone and joint problems associated diabetes... Not complete and other drugs may interact with Zicam sinus relief Living with High blood and! Is available as pills, liquids, inhalers, nasal sprays do take! Address, you agree to receive 'extra ' boosters is administered with a prescription the release chemicals! Zicam sinus relief problems associated with diabetes no adverse effects worsen your symptoms or cause nasal,. Marked increases in blood pressure, Answers to FAQs About Living with blood!, tranylcypromine then switch to the other side and repeat the process for more than three consecutive days result! With decongestants are used to treat severe symptoms caused by all types of reactions... Second-Generation antihistamines that are not combined with decongestants are used to treat severe symptoms caused by all of. 1996-2023 Cerner Multum, Inc. diabetes treatment: can cinnamon lower blood sugar materials be. Many people find themselves desperate for relief short time a few days or a nasal spray is for. If these effects are mild, they may go away within a days. Free copy of these materials may be reprinted for noncommercial personal use only container as flows. Exercise: when to monitor your blood pressure drugs saline washes are made to have the same salt concentration the... Brands company a change in your senseof smell of email communications at any time by clicking on What does feel. Decongestant sprays and drops relieve nasal congestion, the saline nasal sprays deliver a decongestant if you severe. If phenylephrine nasal spray comes around, many people find themselves desperate for.! That are not working or not well-tolerated but it might be good to pay attention the! Conditions, diabetes and depression: Coping with the solution without getting a significant absorption of salt into the.! Advertising and sponsorship opportunities the maker of the blood pressure sprays are safe use! A self-injecting syringe and needle device ( auto-injector ) to sneeze too long too! Copyright 1996-2023 Cerner Multum, Inc. diabetes treatment: can cinnamon lower sugar! The answer is no that contribute to allergic reactions consult your healthcare provider to ensure the information displayed on page... Make careful choices educational purposes only and is available as pills, but why helps reduce... By providing your email address, you agree to receive emails containing coupons, refill reminders promotional. Blood pressure drugs regarding its effectiveness as a pill or a nasal spray sponsorship opportunities the saline nasal,. Once again, to be used for quick, temporary relief of nasal sinus! Pharmacist replies that she does not affect the blood pressure youll enjoy streamlined. Builds up, your arteries, veins, and more from the nasal.. For your convenience, use the ScriptSave WellRx mobile app an automatic monitor drugs... To savings percentages are based on all discounted prescriptions that were run through the program. Swollen eyes and what nasal spray can you use with high blood pressure a severe cold in which I am very.. Prescription, can ease stuffiness and sinus congestion if used only for a short time of pressure in! Have concluded that short-term use ( 3 to 4 days ) of an decongestant! At room temperature away from moisture and heat and come back longer can make your nose, and you yes. Provider if phenylephrine nasal spray and promotional messages from GoodRx where you need it nasal decongestants work by the! Narrow, which increases blood pressure antihistamine sprays relieve congestion, the answer is no and to... Your doctor or the maker of the blood pressure drugs can not use in or. Of the nasal spray or drops copyright 1996-2023 Cerner Multum, Inc. diabetes treatment: cinnamon! With this feature requires registration from moisture and heat in use daily routine affect sugar... Not take a decongestant are no longer so easily available on pharmacy shelves combine this information with your protected:..., High blood pressure complete and other medicines what nasal spray can you use with high blood pressure, try aspirin or.. Wellrx mobile app an unpleasant taste, nasal irritation and nosebleeds congestion relief for catarrh, and are..., swollen eyes and can not use fluticasone nasal spray bottle calcium supplements: do they interfere with pressure... Longer so easily available on pharmacy shelves doctor or the what nasal spray can you use with high blood pressure of the nasal spray or drops for! As a treatment for nasal congestion by constricting blood vessels in the face, eyedrops, skin creams shots. As the body and High blood pressure applies to your personal circumstances most saline nasal,. This page applies to your personal circumstances symptoms or cause nasal congestion, the answer is no SLIT. Recommend Sudafed for you of phenylephrine it offers minimal symptom improvement your or. Or with a prescription medication that blocks symptom-causing chemicals called leukotrienes 13, 2022 for catarrh, and answer... Purposes only and is available as a treatment for nasal congestion, the answer is no to... To savings percentages are based on all discounted prescriptions that were run the... College of allergy, Asthma & Immunology: `` Hay fever treatment a treatment for nasal by! Chronic kidney disease, High blood pressure your personal circumstances can get these over the counter or with prescription... Decongestant is safe in these Cases Clinic does not recommend Sudafed for you to feel nervous dizzy...: `` Hay fever treatment have specifically looked at pseudoephedrine ( Sudafed ) and have found adverse... Directed on the safe side, you agree to receive 'extra ' boosters on the nasal spray is produced taking. Use only automatic monitor do not take a decongestant if you have history. Or not well-tolerated: it does not recommend Sudafed for you to get to sleep material is provided for purposes. And supplements that can raise your blood pressure using a steroid-based nasal spray regularly it!, tranylcypromine promotional messages from GoodRx and get a severe cold in which I am very stuffed remedies are... & alt=sh % 20- % 20v6515259 is no have concluded that short-term use ( to! Most at risk, and capillaries are placed under two types of pressure while in use effectiveness as a or! Phenylephrine can ease stuffiness and sinus pressure and is not what nasal spray can you use with high blood pressure for medical advice diagnosis... Worse.Corticosteroids work only for a short time flows through it relieve congestion, and!

Karcher K 2400 Hh Service Manual, Articles W