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

BMC Cardiovascular Disorders

Research Article

Richard A Hansen¹  Susan J Blalock²  D Craig Brater³  Wanzhu Tu⁴  Hisham Aljadhey⁵  Michael D Murray⁶ 

[1] Department of Pharmacy Care Systems, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA;Division of Pharmaceutical Outcomes & Policy, School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA;Indiana University School of Medicine, Indianapolis, IN, USA;Indiana University School of Medicine, Indianapolis, IN, USA;Regenstrief Institute, Inc, Indianapolis, IN, USA;Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia;Regenstrief Institute, Inc, Indianapolis, IN, USA;Purdue University College of Pharmacy, West Lafayette, IN, USA;

关键词: NSAIDs;    Hypertension;    Blood pressure;    Propensity score;   

DOI  :  10.1186/1471-2261-12-93

 received in 2012-06-08, accepted in 2012-10-15,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundNonsteroidal 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.MethodsWe 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.ResultsCompared 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.ConclusionCompared 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.

【 授权许可】

CC BY   
© Aljadhey et al.; licensee BioMed Central Ltd. 2012