Study: NSAIDs, Acetaminophen Increase Risk of Hypertension

Men who take acetaminophen, aspirin or other types of nonsteroidal anti-inflammatory drugs, known as NSAIDs, six to seven days a week have an increased risk of developing hypertension, according to the abstract of a study in the Feb. 26 Archives of Internal Medicine.

Frequent acetaminophen users had a 34 percent higher risk of developing hypertension than nonusers; NSAID and aspirin users had 38 percent and 26 percent greater risks, respectively, the study found. Similar results were observed when the number of pills taken per week was analyzed rather than frequency of use in days per week.

"Acetaminophen, ibuprofen and aspirin are the three most frequently used drugs in the United States," say the authors in the report. "Given their common consumption and the high prevalence of hypertension (in the United States), our results may have substantial public health implications, and suggest that these agents be used with greater caution."

The authors observed a stronger association between acetaminophen use and hypertension among leaner men than among heavier men. Conversely, "the association between NSAIDs and hypertension was more pronounced in heavier compared with leaner men," say the report's authors.

Information was gleaned from 16,031 male health professionals through the biennial Health Professionals Follow-up Study questionnaire. The average age of respondents was 65, and they had no history of hypertension at baseline. Information about frequency of drug use was first gathered as part of this ongoing prospective cohort study in 2000; relative risk of hypertension was analyzed during four years of follow-up research.

Researchers did not directly examine participants to confirm hypertension; self-diagnosis of hypertension was earlier found to be highly reliable in this ongoing health professionals study. The findings in the current study were consistent with similar research conducted on women as part of the Nurses' Health Study.

In related news, the American Heart Association, or AHA, recently released a statement recommending physicians change the way they prescribe pain relievers for patients who have or are at risk for heart disease based on growing evidence that NSAIDs, with the exception of aspirin, increase the risk for cardiovascular disease or stroke.

"We advise physicians to start (pain management) with nonpharmacologic treatments such as physical therapy and exercise, weight loss to reduce stress on joints, and heat or cold therapy," said Elliott Antman, M.D., lead author of the AHA scientific statement and professor of medicine at Harvard Medical School and Brigham and Women's Hospital, Boston. "If the nonpharmacologic approach does not provide enough pain relief or control of symptoms, we recommend a stepped-care approach when it comes to prescribing drugs."

The statement is based on a meta-analysis that indicates COX-2 selective drugs increase heart attack risk by about 86 percent compared with placebo, and that some common NSAIDs appear to increase the "relative risk of cardiovascular disease," according to the AHA release.