Which drug interaction leads to a risk of hypertensive crisis?

The interaction between aged cheese and wine poses a significant risk of hypertensive crisis due to their content of tyramine. Tyramine is an amino acid that can trigger the release of norepinephrine, a neurotransmitter that can lead to increased blood pressure when it builds up in the body. This is particularly relevant for individuals taking monoamine oxidase inhibitors (MAOIs), which inhibit the breakdown of tyramine. When someone on an MAOI consumes foods like aged cheese and wine, which are high in tyramine, it can lead to an excessive accumulation of norepinephrine and result in a hypertensive crisis, characterized by dangerously elevated blood pressure and potential complications.

The other interactions listed do not present the same risk of hypertensive crisis. Leafy, green vegetables and warfarin can affect coagulation levels but not blood pressure in this acute manner. Antacids and antibiotics may alter the absorption of antibiotics but are not known for causing hypertension. Statins and grapefruit juice interaction can affect cholesterol metabolism, but it does not lead to hypertensive crises. Thus, the combination of aged cheese and wine is uniquely associated with the risk of hypertensive crisis in certain populations, notably those using MAOIs.