Some pain relievers may raise blood pressure

NEW YORK (Reuters Health) - Higher daily doses of some commonly used non-aspirin pain-relievers increase the risk of high blood pressure in women, the results of two studies suggest. "Our results have substantial public health implications," the researchers write, "and suggest that these agents be used with greater caution."

Although previous research has indicated a link between high blood pressure, also referred to as hypertension, and analgesic use, those analyses failed to take into account drug doses and the reasons for their use, Dr. John P. Forman and colleagues note in their report the medical journal Hypertension.

The researchers at Harvard School of Public Health in Boston therefore undertook a new project using different groups of participants the Nurses' Health Study, a large ongoing clinical trial, to take into account analgesic doses.

The first study included 1,903 women who were between 30 and 55 years old in 1976; the second study included 3,220 women who were between 25 and 42 years old in 1989. In both groups, the women with a history of hypertension in 1999 and 1998, respectively, were excluded.

The risk of hypertension was estimated using analyses that took into account other risk factors including age, body mass index, level of physical activity, smoking, family history of hypertension, the use of alcohol, caffeine, folic acid supplements and birth control pills.

The nonsteroidal anti-inflammatory drugs (NSAIDs) included ibuprofen, naproxen, celecoxib and other NSAIDs.

In the first group, there were 211 cases of hypertension identified during follow-up. The corresponding number in the second group was 299.

In the first group, women who took acetaminophen at doses greater than 500 milligrams per day had a 93-percent increased risk of hypertension. The increased risk associated with taking greater than 400 milligrams per day of NSAIDs was 78 percent.

The increased risk in the second group of women was 99 percent for the higher doses of acetaminophen and 60 percent for NSAIDs.

In neither group was aspirin at doses of 400 milligrams per day significantly associated with increased hypertension risk.

The investigators point out that these pain relievers are commonly used in the United States and suggest that the drugs "may contribute to the high prevalence of hypertension."

SOURCE: Hypertension, August 15, 2005.