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Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension.
BMC Cardiovasc Disord. 2012 Oct 24; 12:93.BC

Abstract

BACKGROUND

Nonsteroidal anti-inflammatory drugs (NSAIDs) may disrupt control of blood pressure in hypertensive patients and increase their risk of morbidity, mortality, and the costs of care. The objective of this study was to examine the association between incident use of NSAIDs and blood pressure in patients with hypertension.

METHODS

We conducted a retrospective cohort study of adult hypertensive patients to determine the effects of their first prescription for NSAID on systolic blood pressure and antihypertensive drug intensification. Data were collected from an electronic medical record serving an academic general medicine practice in Indianapolis, Indiana, USA. Using propensity scores to minimize bias, we matched a cohort of 1,340 users of NSAIDs with 1,340 users of acetaminophen. Propensity score models included covariates likely to affect blood pressure or the use of NSAIDs. The study outcomes were the mean systolic blood pressure measurement after starting NSAIDs and changes in antihypertensive therapy.

RESULTS

Compared to patients using acetaminophen, NSAID users had a 2 mmHg increase in systolic blood pressure (95% CI, 0.7 to 3.3). Ibuprofen was associated with a 3 mmHg increase in systolic blood pressure compared to naproxen (95% CI, 0.5 to 4.6), and a 5 mmHg increase compared to celecoxib (95% CI, 0.4 to 10). The systolic blood pressure increase was 3 mmHg in a subgroup of patients concomitantly prescribed angiotensin converting enzyme inhibitors or calcium channel blockers and 6 mmHg among those prescribed a beta-adrenergic blocker. Blood pressure changes in patients prescribed diuretics or multiple antihypertensives were not statistically significant.

CONCLUSION

Compared to acetaminophen, incident use of NSAIDs, particularly ibuprofen, is associated with a small increase in systolic blood pressure in hypertensive patients. Effects in patients prescribed diuretics or multiple antihypertensives are negligible.

Authors+Show Affiliations

College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. haljadhey@ksu.edu.saNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23092442

Citation

Aljadhey, Hisham, et al. "Comparative Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) On Blood Pressure in Patients With Hypertension." BMC Cardiovascular Disorders, vol. 12, 2012, p. 93.
Aljadhey H, Tu W, Hansen RA, et al. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012;12:93.
Aljadhey, H., Tu, W., Hansen, R. A., Blalock, S. J., Brater, D. C., & Murray, M. D. (2012). Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovascular Disorders, 12, 93. https://doi.org/10.1186/1471-2261-12-93
Aljadhey H, et al. Comparative Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) On Blood Pressure in Patients With Hypertension. BMC Cardiovasc Disord. 2012 Oct 24;12:93. PubMed PMID: 23092442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. AU - Aljadhey,Hisham, AU - Tu,Wanzhu, AU - Hansen,Richard A, AU - Blalock,Susan J, AU - Brater,D Craig, AU - Murray,Michael D, Y1 - 2012/10/24/ PY - 2012/06/08/received PY - 2012/10/15/accepted PY - 2012/10/25/entrez PY - 2012/10/25/pubmed PY - 2013/1/30/medline SP - 93 EP - 93 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 12 N2 - BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) may disrupt control of blood pressure in hypertensive patients and increase their risk of morbidity, mortality, and the costs of care. The objective of this study was to examine the association between incident use of NSAIDs and blood pressure in patients with hypertension. METHODS: We conducted a retrospective cohort study of adult hypertensive patients to determine the effects of their first prescription for NSAID on systolic blood pressure and antihypertensive drug intensification. Data were collected from an electronic medical record serving an academic general medicine practice in Indianapolis, Indiana, USA. Using propensity scores to minimize bias, we matched a cohort of 1,340 users of NSAIDs with 1,340 users of acetaminophen. Propensity score models included covariates likely to affect blood pressure or the use of NSAIDs. The study outcomes were the mean systolic blood pressure measurement after starting NSAIDs and changes in antihypertensive therapy. RESULTS: Compared to patients using acetaminophen, NSAID users had a 2 mmHg increase in systolic blood pressure (95% CI, 0.7 to 3.3). Ibuprofen was associated with a 3 mmHg increase in systolic blood pressure compared to naproxen (95% CI, 0.5 to 4.6), and a 5 mmHg increase compared to celecoxib (95% CI, 0.4 to 10). The systolic blood pressure increase was 3 mmHg in a subgroup of patients concomitantly prescribed angiotensin converting enzyme inhibitors or calcium channel blockers and 6 mmHg among those prescribed a beta-adrenergic blocker. Blood pressure changes in patients prescribed diuretics or multiple antihypertensives were not statistically significant. CONCLUSION: Compared to acetaminophen, incident use of NSAIDs, particularly ibuprofen, is associated with a small increase in systolic blood pressure in hypertensive patients. Effects in patients prescribed diuretics or multiple antihypertensives are negligible. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/23092442/Comparative_effects_of_non_steroidal_anti_inflammatory_drugs__NSAIDs__on_blood_pressure_in_patients_with_hypertension_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-12-93 DB - PRIME DP - Unbound Medicine ER -