Effects of low-dose aspirin on clinic and ambulatory blood pressure in treated hypertensive patients

Abstract

Nonsteroidal antiinflammatory drugs may affect blood pressure (BP) control in hypertensive patients receiving drug treatment, but data on the effects of low-dose aspirin are scanty. This study assessed the effects of chronic treatment with low doses of aspirin (100 mg/day) on clinic and ambulatory systolic (SBP) and diastolic (DBP) BP in hypertensives on chronic, stable antihypertensive therapy. The study was conducted in the framework of the Primary Prevention Project (PPP), a randomized, controlled factorial trial on the preventive effect of aspirin or vitamin E in people with one or more cardiovascular risk factors. Fifteen Italian hypertension units studied 142 hypertensive patients (76 men, 66 women; mean age 59 +/- 5.9 years) treated with different antihypertensive drugs: 71 patients were randomized to aspirin and 71 served as controls. All patients underwent a clinic BP evaluation with an automatic sphygmomanometer and a 24-h ambulatory BP monitoring, at baseline and after 3 months of aspirin treatment. At the end of the study the changes in clinic SBP and DBP were not statistically different in treated and untreated subjects. Ambulatory SBP and DBP after 3 months of aspirin treatment were similar to baseline: deltaSBP -0.5 mmHg (95% confidence intervals [CI] from -1.9 to +2.9 mm Hg) and deltaDBP -1.1 mm Hg (95% CI from -2.5 to +0.3 mm Hg). The pattern was similar in the control group. No interaction was found between aspirin and the most used antihypertensive drug classes (angiotensin converting enzyme inhibitors and calcium antagonists). Despite the relatively small sample size our results seem to exclude any significant influence of low-dose aspirin on BP control in hypertensives under treatment.

Effects of low-dose aspirin on blood pressure and endothelial function of treated hypertensive hypercholesterolaemic subjects

“…Similar effects of bedtime low-dose aspirin on BP were observed in a study on pregnant women, 7 but another study 8 did not find any significant influence of 3 months treatment with morning low-dose aspirin on BP control in treated hypertensive subjects. There may be several reasons why our study has shown a change in BP, when other studies in the past have not done so.…”

“…[5][6][7] Other studies have shown no influence of low-dose aspirin on BP in hypertensive patients 8,9 Influence of aspirin on BP was found to be dose and administration-time dependent…”

“…1 Although aspirin is the most frequently used medication for the prevention of cardiovascular diseases, 2-4 few reports exist about its influence on blood pressure (BP) control in hypertensive subjects. [5][6][7] These studies have shown no influence of low-dose aspirin on BP in hypertensive patients 8,9 (Table 1). Other nonsteroidal antiinflammatory medications (NSAIDs) have been shown be able to increase BP both in normotensive and hypertensive subjects 5,[10][11][12] and this BP elevating effect of NSAIDs appears more marked in hypertensive subjects under treatment.…”

Time-Dependent Effects of Low-Dose Aspirin on Plasma Renin Activity, Aldosterone, Cortisol, and Catecholamines

“…3 Notably, in studies addressing this association, it was not reported at what time of the day aspirin was ingested by the participants. [5][6][7] In contrast, 2 recent randomized, controlled trials by Hermida et al 8,9 have shown that 100 mg of aspirin strongly decreased blood pressure in subjects with grade 1 essential hypertension when it was administered at bedtime, whereas (if anything) blood pressure might be slightly increased when aspirin was taken on awakening. In the subjects allocated to aspirin at evening, reductions of systolic and diastolic blood pressures of, respectively, 7.2/4.9 and 6.8/4.6 mm Hg (systolic/diastolic blood pressure) were recorded, whereas in the participants using aspirin at morning, a slight elevation of, respectively, 1.5/1.0 and 2.6/1.6 mm Hg was observed.…”

Features of Treatment for Articular Syndrome in Elderly Patients With Arterial Hypertension Specific

“…По мнению ряда ав-торов, это связано с задержкой натрия на фоне изменений почечного кровотока и скорости клубочковой фильтрации. При этом у людей, не чувствительных к соли, АД может не меняться в ответ на прием НПВП [17].…”