Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension

Hisham Aljadhey, Wanzhu Tu, Richard A. Hansen, Susan J. Blalock, D. C. Brater, Michael Murray

Research output: Contribution to journalArticle

32 Citations (Scopus)

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.

Original languageEnglish
Article number93
JournalBMC cardiovascular disorders [electronic resource]
Volume12
DOIs
StatePublished - Oct 24 2012

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Anti-Inflammatory Agents
Blood Pressure
Hypertension
Pharmaceutical Preparations
Antihypertensive Agents
Acetaminophen
Propensity Score
Ibuprofen
Celecoxib
Diuretics
Naproxen
Adrenergic beta-Antagonists
Electronic Health Records
Calcium Channel Blockers
Drug Users
Angiotensin-Converting Enzyme Inhibitors
General Practice
Prescriptions
Cohort Studies
Retrospective Studies

Keywords

  • Blood pressure
  • Hypertension
  • NSAIDs
  • Propensity score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. / Aljadhey, Hisham; Tu, Wanzhu; Hansen, Richard A.; Blalock, Susan J.; Brater, D. C.; Murray, Michael.

In: BMC cardiovascular disorders [electronic resource], Vol. 12, 93, 24.10.2012.

Research output: Contribution to journalArticle

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