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

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Creator
  • Hansen, Richard A
    • Other Affiliation: Department of Pharmacy Care Systems, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
  • Tu, Wanzhu
    • Other Affiliation: Indiana University School of Medicine, Indianapolis, IN, USA; Regenstrief Institute, Inc, Indianapolis, IN, USA
  • Murray, Michael D
    • Other Affiliation: Regenstrief Institute, Inc, Indianapolis, IN, USA; Purdue University College of Pharmacy, West Lafayette, IN, USA
  • Blalock, Susan
    • Affiliation: Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy
  • Aljadhey, Hisham
    • Other Affiliation: Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
  • Brater, D
    • Other Affiliation: Indiana University School of Medicine, Indianapolis, IN, USA
Abstract
  • 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.
Date of publication
Identifier
  • 23092442
  • doi:10.1186/1471-2261-12-93
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Hisham Aljadhey et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Cardiovascular Disorders
Journal volume
  • 12
Journal issue
  • 1
Page start
  • 93
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2261
Bibliographic citation
  • BMC Cardiovascular Disorders. 2012 Oct 24;12(1):93
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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