Attenuation of hypotensive effect of propranolol and thiazide diuretics by indomethacin.

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…218 -221 NSAIDs may also contribute to increased vascular resistance due to increased ET-1 synthesis and/or altered arachidonic metabolism. [222][223][224][225][226] They also interfere with BP control in the elderly through partial reversal of antihypertensive effects of diuretics, 218,[227][228][229][230] beta-receptor antagonists, and ACEIs [231][232][233] and ARBs, but not CAs. NSAIDs antagonize antihypertensive effects of beta blockers more than vasodilators or diuretics.…”

Flurbiprofen interaction with single doses of atenolol and propranolol.

“…Enhancement of unopposed (Raine & Pickering, 1977). Nevertheless, it is of interest that the degree of attenuation of the effects of single doses of propranolol in reducing blood pressure is of the same order as that exhibited by indomethacin on the longer term response to propranolol (Watkins et al, 1980). The design of our study requires comment.…”

“…For example, the antihypertensive efficacy of propranolol (Durao et al, 1977;Watkins et al, 1980), oxprenolol (Salvetti et al, 1982a) and atenolol (Salvetti et al, 1982b) appear to be attenuated by indomethacin. In contrast, other NSAID such as sulindac (Salvetti et al, 1983), naproxen and aspirin (Chalmers et al, 1983) appear not to be implicated in such effects.…”

The influence of prostaglandin inhibition by indomethacin on blood pressure and renal function in hypertensive patients treated with cilazapril.

“…Non-steroidal anti-inflammatory drugs (NSAID) are known to attenuate the antihypertensive effect of 3-adrenoceptor blockers, thiazide diuretics and ACE inhibitors (Watkins et al, 1980;Steines, 1982;Salvetti et al, 1982;Pedrinelli et al, 1982;Patak et al, 1985;Koopmans et al, 1987;Koopmans et al, 1985;Koopmans et al, 1984;Fujita et al, 1981;Dixey et al, 1987). The prostaglandin and the reninangiotensin-aldosterone system (RAAS) as well as alterations in renal function appear to be involved in the interactions mentioned (Quilley et al, 1987;Fujita et al, 1981;Belz et al, 1988).…”