Medical Blogs

March 4, 2007

High Blood Pressure Linked To Painkillers


American researchers have shown that men who use painkillers frequently risk higher blood pressure compared to those that do not.

The study is published in the journal Archives of Internal Medicine.

The team that did the research is from Brigham and Women's Hospital, Harvard Medical School and Harvard School of Public Health, Boston.

The researchers recruited 16,031 male health professionals of average age 65 with no history of high blood pressure (hypertension) and followed them over a four year period.

They measured their use of painkillers, or analgesics, by taking detailed information at the start and two years into the study.

The analgesics they studied were acetaminophen (paracetomol); nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen, and aspirin (which is also a type of NSAID). These are known as non-narcotic analgesics, the most commonly used drugs in the US.

At the end of the 4 year period they identified that 1,968 of the men (12 per cent) had developed hypertension and then they worked out the relative risk of hypertension in relation to analgesic use using regression-based statistical tests.

The relative risk for men who took NSAIDs 6 to 7 days a week was 38 per cent - they were 38 per cent more likely to develop high blood pressure than the men who took no painkillers at all. The relative risk of developing hypertension in the men who took acetaminophen (paracetomol) was 34 per cent and aspirin 26 per cent.

The results were very similar when number of pills per week was used as a frequency measure instead of days per week.

They concluded that the use of non-narcotic analgesics such as ibuprofen, aspirin and acetaminophen (paracetomol) is independently associated with a moderate increase in blood pressure. This finding has important implications for public health since this kind of medication is in widespread use throughout America.

High blood pressure is associated with increased risk of heart attack, heart failure, stroke, arterial aneurysm and kidney failure. The American Heart Association calls it the "silent killer".

72 million Americans aged 20 and over have high blood pressure (about one in three adults), and over 50,000 of them are killed by it every year. Most people with high blood pressure are unaware of their condition.

Acetaminophen (or paracetomol) is commonly known as Tylenol and Panadol and is available over the counter. It has analgesic (painkilling) and antipyretic (fever reducing) effects but is not effective as an anti-inflammatory. One little known fact is that it is highly toxic to cats.

NSAIDs such as ibuprofen and aspirin are also available over the counter and are effective as painkillers, fever reducers and anti-inflammatories.

There are hundreds of different NSAIDs, with broadly similar properties, the main differences being in the way they are taken, tolerance by patients, and how long they last in the body before being eliminated.

According to the Mayo Clinic, your blood pressure is normal if it's below 120 over 80 but they say that many studies suggest that 115 over 75 is a better standard.

The researchers were keen to point out that this research was not about the risk of painkillers to people who are taking them under doctor's advice to reduce the risk of stroke and heart attack. For instance aspirin is often used in this way. If you are such a patient you should continue to follow your doctor's advice, they said.

"Frequency of Analgesic Use and Risk of Hypertension Among Men."
John P. Forman, Eric B. Rimm, Gary C. Curhan.
Arch Intern Med. 2007;167:394-399.
Vol. 167 No. 4, February 26, 2007

Click here for Abstract.

Click here for the American Heart Association.

Written by: Catharine Paddock
Writer: Medical News Today

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