A Meta-analysis of the Effects of Nonsteroidal Anti-inflammatory Drugs on Blood Pressure

Abstract

In short-term use, NSAIDs vary considerably in their effect on blood pressure. Of the drugs studied, indomethacin and naproxen were associated with the largest increases in blood pressure. The average effects of piroxicam, aspirin, ibuprofen, and sulindac were negligible.

NSAID use and BP in treated hypertensives: a retrospective controlled observational study

“…'s (equivalent to 4 mmHg systolic and 2.5 mmHg diastolic), with 80% power and twosided 5% alpha and a ratio of four NSAID nonusers to every one NSAID user. This difference was based on meta-analysis 4 findings of up to 3 mmHg difference in mean BP for NSAIDs.…”

“…Osteoarthritis (OA) is also common in the elderly and is the commonest comorbid condition in the elderly hypertensive population. 4 NSAIDs are commonly prescribed in OA despite other analgesics providing equivalent symptomatic relief. 5 Ibuprofen and diclofenac account for d80 million in general practice prescribing in England per annum (years 2001-2002).…”

“…Prostaglandins are naturally occurring vasodilators and interact with the reninangiotensin system. 4,[8][9][10][11] Previous studies 4,9,10,12 on NSAIDs and hypertension have produced conflicting results and examined relationships between NSAID usage in nontreated and treated patients. Some NSAIDs (particularly indometacin and naproxen 4 may elevate BP and attenuate the effects of antihypertensives, on average being associated with 5 mmHg rise in mean BP.…”

“…4,[8][9][10][11] Previous studies 4,9,10,12 on NSAIDs and hypertension have produced conflicting results and examined relationships between NSAID usage in nontreated and treated patients. Some NSAIDs (particularly indometacin and naproxen 4 may elevate BP and attenuate the effects of antihypertensives, on average being associated with 5 mmHg rise in mean BP. 9 Some evidence 4 suggests that this may not be a class effect and that not all NSAIDs (eg ibuprofen) will raise BP in this way.…”

“…Some NSAIDs (particularly indometacin and naproxen 4 may elevate BP and attenuate the effects of antihypertensives, on average being associated with 5 mmHg rise in mean BP. 9 Some evidence 4 suggests that this may not be a class effect and that not all NSAIDs (eg ibuprofen) will raise BP in this way. As hypertension and coprescribing of NSAIDs are common in the elderly, any adverse effects from coprescribing may potentially affect a substantial proportion of the elderly community.…”