Influence of non-steroidal anti-inflammatory drugs on renal function and 24 h ambulatory blood pressure-reducing effects of enalapril and nifedipine gastrointestinal therapeutic system in hypertensive patients

Polónia, Jorge; Boaventura, I; Gama, Guilherme; Camões, Isabel; Bernardo, Fátima; Andrade, José Paulo; Nunes, José Pedro L.; Brandão, Fátima; Cerqueira-Gomes, M

doi:10.1097/00004872-199508000-00014

Cited by 56 publications

(37 citation statements)

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“…So far, no interaction has been found, though the number of patients involved in these studies was very small (less than 19 patients). 22,23 On the other hand, Hermida et al reported an inverse association between aspirin intake (100 mg/day) given before bed-time and mean 24 hour BP levels (-6/-4 mm Hg reduction of systolic BP/ diastolic BP) 10 especially in non-dippers. 11 24 Two meta-analyses assessing the association of aspirin and other NSAIDs with BP levels have been published.…”

Section: Discussionmentioning

confidence: 99%

Aspirin, Non-Aspirin Analgesics and the Risk of Hypertension in the SUN Cohort

Beunza

Martínez‐González

Bes–Rastrollo

et al. 2010

Revista Española de Cardiología (English Edition)

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Introduction and objectives. The use of aspirin and non-aspirin analgesics have been associated with changes in blood pressure. The aim of this study was to investigate prospectively the association between the regular use of aspirin and non-aspirin analgesics and the incidence of hypertension.Methods. The SUN project is an ongoing, continuously expanding, prospective cohort of Spanish university graduates initially free of hypertension, cardiovascular disease, diabetes, and cancer; 9986 (mean age, 36 years) were recruited during 1999-2005 and followed up for a mean of 51 months. Regular aspirin and non-aspirin analgesic use and the presence of other risk factors for hypertension were assessed by questionnaire at baseline, and the incidence of hypertension was assessed using biennial follow-up questionnaires.Results. In total, 543 new cases of hypertension were identified during follow-up. Regular aspirin use (ie, ≥2 days/ week) was associated with a higher risk of hypertension (hazard ratio = 1.45; 95% confidence interval, 1.02-2.04) after adjustment for various confounding factors. Regular use of non-aspirin analgesic drugs was also associated with a higher risk of hypertension (hazard ratio = 1.69; 95% confidence interval, 1.28-2.23).Conclusions. The regular use of aspirin and non-aspirin analgesics were both associated with an increased risk of developing hypertension, independently of other risk factors. Aspirina, analgésicos y riesgo de hipertensión arterial en la Cohorte SUN Introducción y objetivos. Se ha relacionado el consumo de aspirina y de otros analgésicos con cambios en la presión arterial. El objetivo de nuestro estudio fue valorar prospectivamente la asociación del uso habitual de aspirina y otros analgésicos con la incidencia de hipertensión arterial.Métodos. El proyecto SUN es una cohorte prospectiva y dinámica que incluyó a 9.986 graduados universitarios españoles inicialmente libres de hipertensión, enfermedad cardiovascular, diabetes o cáncer (media de edad, 36 años). Fueron reclutados durante el periodo 1999-2005 y se los siguió prospectivamente durante una media de 51 meses. El uso habitual de aspirina y otros analgési-cos, así como la presencia de otros factores de riesgo de hipertensión arterial, se valoró mediante un cuestionario basal. La incidencia de hipertensión se valoró con cuestionarios de seguimiento bienales.Resultados. Durante el seguimiento se identificaron 543 casos nuevos de hipertensión arterial. El uso habitual de aspirina (2 o más días/semana) se asoció con un mayor riesgo de hipertensión (hazard ratio [HR] = 1,45; intervalo de confianza [IC] del 95%, 1,02-2,04) tras ajustar por diversos factores de confusión. El uso habitual de otros analgésicos diferentes de la aspirina también se asoció a un mayor riesgo de hipertensión arterial (HR = 1,69; IC del 95%, 1,28-2,23).Conclusiones. El uso habitual tanto de aspirina como de otros analgésicos diferentes a la aspirina parece asociarse a mayor riesgo de hipertensión arterial, independientemente de otros factores de riesgo.

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Section: Discussionmentioning

confidence: 99%

Aspirin, Non-Aspirin Analgesics and the Risk of Hypertension in the SUN Cohort

Beunza

Martínez‐González

Bes–Rastrollo

et al. 2010

Revista Española de Cardiología (English Edition)

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“…wilson and Poulter [16] cited three studies in their review comparing the influence of indomethacin on the ACE inhibitor enalapril and on calcium channel blockers such as nifedipine [34], felodipine [35] and amlodipine [36]. The results of these studies were very similar.…”

Section: The Influence Of Nsaids On Blood Pressure Levelmentioning

confidence: 97%

“…As mentioned above, not all NSAIDs influence blood pressure to an equal extent; they can be divided into one group with a stronger influence on blood pressure and another group with little or no influence. It has been assumed that the pro-hypertensive effect of NSAIDs is associated with sodium and fluid retention [34]. Indomethacin, naproxen and piroxicam increase blood pressure more efficiently in comparison with sulindac or aspirin [19,32].…”

Section: The Influence Of Nsaids On Blood Pressure Levelmentioning

confidence: 99%

“…The results of these studies were very similar. In the study listed first, by Polonia et al [34], eighteen randomized patients were taking enalapril/indomethacin or nifedipine/indomethacin over a period of one week. In the enalapril/indomethacin group, the increase in blood pressure was 6.8 mm Hg, while in the nifedipine/indomethacin group it was only 0.3 mm Hg.…”

Section: The Influence Of Nsaids On Blood Pressure Levelmentioning

confidence: 99%

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The Impact of Combinations of Non-Steroidal Anti-Inflammatory Drugs and Anti-Hypertensive Agents on Blood Pressure

Kalafutova¹,

Jurašková

Vlček³

2014

Adv Clin Exp Med

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Nowadays NSAIDs are the most frequently used groups of drugs, especially because of their availability. Their consumption is high among older people, who are much more sensitive to the side effects, and who are often also taking other drugs which can interact with them. Moreover, the majority of the older population is suffering from hypertension. This could well explain the commonly encountered experience of drug interaction between NSAIDs and antihypertensive drugs, which is very common in clinical practice. The severity of this drug interaction is classified as class C, with a recommendation to monitor therapy. However, even a minor long-term increase in blood pressure can significantly increase the risk of cardiovascular mortality, while mortality rates can possibly be reduced by sufficiently effective treatment of hypertension. Therefore, in clinical practice, this type of interaction should not be overlooked as a major cause of failure of hypertension treatment in older patients, as well in many cases in general. The present article focusses on the mechanism and the degree of influence on the blood pressure of particular types of antihypertensive agents used in combination with NSAID. Not all groups of antihypertensive drugs are affected to the same degree; some are more affected, and others, such as calcium channel blockers, are not affected at all. Similarly, not every NSAID increases blood pressure. Many studies, some of which are analyzed in this article, present evidence of the degree of the influence NSAIDs have on blood pressure (Adv Clin Exp Med 2014, 23, 6, 993-1000). Hypertension is well known as one of the most common cardiovascular diseases. Approximately 690 m people around the world suffer from hypertension. It is one of the major risk factors causing arteriosclerosis, including atherogenic coronary artery disease in the form of ischemic heart disease [1]. Hypertension affects the majority of people over 65 years of age, occurring in up to 60% of this population [2]. In most cases, it accounts for subsequent organ damage or many other manifestations of cardiovascular diseases [2,3]. Adequate treatment of hypertension is important especially in older populations, as has been confirmed by the HYVET study [4]. Moreover, older populations often experience pain, both chronic and acute. The use of different analgesics therefore becomes a regular part of their lives. It should therefore be borne in mind that the treatment of hypertension may be significantly influenced by the concomitant use of other therapeutic classes.The authors of this article focused on clarifying the mechanisms of the influence on blood

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“…It should be noted that isradipine is a relatively short-acting agent, likely to induce sympathetic stimulation. Preservation of Antihypertensive Efficacy with NSAIDs: All classes of antihypertensives except CCBs have their efficacy blunted by concomitant intake of NSAIDs (19). Preservation o f Antihypertensive Efficacy with High Sodium Intake: CCBs may also be unique in not having their antihypertensive efficacy blunted but rather enhanced by the usual high sodium intake of most people (20).…”

Section: Ancillary Propertiesmentioning

confidence: 99%

The Calcium Channel Blocker Controversy.

Kaplan

1996

Hypertens Res

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A major controversy about the safety of calcium channel blockers (CCBs) has arisen since the publication of a case-control study showing that hypertensives who suffered an acute myocardial infarction (MI) were more likely than hypertensives who had not had an MI to be taking one of these (short-acting) agents than other antihypertensive agents. This study was accompanied by a republication of older studies showing that large doses of short-acting nifedipine given to post-MI patients increased their mortality rate. The danger of massive doses of short-acting nifedipine in a post-MI patient is real but irrelevant to current practice. On the other hand, the putative dangers of short-acting CCBs in the treatment of hypertension do not apply to the current use of long-acting CCBs. Therefore the scare over their use is both irrational and unfortunate. (Hypertens Res 1996; 19: 57-64)

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Influence of non-steroidal anti-inflammatory drugs on renal function and 24 h ambulatory blood pressure-reducing effects of enalapril and nifedipine gastrointestinal therapeutic system in hypertensive patients

Cited by 56 publications

References 0 publications

Aspirin, Non-Aspirin Analgesics and the Risk of Hypertension in the SUN Cohort

Aspirin, Non-Aspirin Analgesics and the Risk of Hypertension in the SUN Cohort

The Impact of Combinations of Non-Steroidal Anti-Inflammatory Drugs and Anti-Hypertensive Agents on Blood Pressure

The Calcium Channel Blocker Controversy.

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