NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?

Floor-Schreudering, Annemieke; Smet, Peter A. G. M. De; Buurma, Henk; Kramers, Cornelis; Tromp, P. Chris; Belitser, Svetlana V.; Bouvy, Marcel L.

doi:10.1177/2047487313505243

Cited by 13 publications

(3 citation statements)

References 37 publications

(51 reference statements)

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“…Floor-Schreudering, et al (2015) [13] also observed interference in control of blood pressure in patients taking high dosage of new NSAID etoricoxib.…”

Section: Discussionmentioning

confidence: 96%

Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis

Sollmann

2019

Int J Med Res Rev

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Objective: To study the impact of aceclofenac on antihypertensive action of amlodipine and ramiprilin hypertensive patients with osteoarthritis in an open label case control prospective study. Methods: This was an open label case control prospective study. Hypertensive patients on either amlodipine or Ramipril were included in control groups. A total of 120 patients were included in the study and divided into 4 groups: Group A-Hypertensivepatients on Ramipril; Group B-Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Ramipril; Group C-Hypertensive patients on Amlodipine and Group D-Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Amlodipine. Results: At the end of the first month (phase I) the ramipril subgroup in the control group had a mean systolic blood pressure of 136.73±3.80 which was an 8.19% decrease from the baseline and it was found significant (p<0.05). The systolic blood pressure measurements at the end of the second month (phase II) in the control groups revealed further fall in mean systolic blood pressure. The cases of osteoarthritis on aceclofenacand ramiprilshowedan increase in BP. The mean Systolic BP was 159.2 ± 5.816.An increase of 9.74%from the base line and 16.09% was noted at the end of phase-I (P<0.5). Patients on aceclofenac and amlodipine in contrast showed a fall in BP from base line in phase 0 and their mean systolic blood pressure at positive in of second month of phase-II was 142.07± 2.43 about 1.88% fall baseline and 2.94% increase in BP compared to Phase-I. Almost similar observations were recorded for diastolic blood pressure. Conclusion: The interaction of NSAIDs on the antihypertensive action of the ACE inhibitors is significantly greater than their blunting action on the calcium channel blockers.

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“…Floor-Schreudering, et al (2015) [13] also observed interference in control of blood pressure in patients taking high dosage of new NSAID etoricoxib.…”

Section: Discussionmentioning

confidence: 96%

Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis

Sollmann

2019

Int J Med Res Rev

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“…Through multiple mechanisms related to PG inhibition, NSAIDs may increase blood pressure and blunt the effects of anti-hypertensive drugs, namely ACEis, angiotensin II receptor 1 blockers and thiazide diuretics. 62,63,107 Due to their potential cardiovascular toxicity, patients with pre-existing vascular or cardiac disease should avoid NSAID use, especially 3–6 months after an acute event. Hepatic and renal diseases frequently encountered in elderly patients can alter NSAID pharmacokinetics and pharmacodynamics, thus predisposing them to an increased risk of toxic effects.…”

Section: Discussionmentioning

confidence: 99%

Non-steroidal anti-inflammatory drug effects on renal and cardiovascular function: from physiology to clinical practice

Cabassi

Tedeschi

Perlini

et al. 2019

Eur J Prev Cardiolog

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Excessive or inappropriate use of non-steroidal anti-inflammatory drugs can affect cardiovascular and renal function. Non-steroidal anti-inflammatory drugs, both non-selective and selective cyclooxygenase 2 inhibitors, are among the most widely used drugs, especially in the elderly, with multiple comorbidities. Exposition to a polypharmacy burden represents a favourable substrate for the onset of non-steroidal anti-inflammatory drug-induced deleterious effects. Cardiovascular and renal issues concerning the occurrence of myocardial infarction, atrial fibrillation, heart failure and arterial hypertension, as well as acute or chronic kidney damage, become critical for clinicians in their daily practice. We discuss current available knowledge regarding prostanoid physiology in vascular, cardiac and renal systems, pointing out potential negative non-steroidal anti-inflammatory drug-related issues in clinical practice.

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“…Em relação à associação entre AINE e anti-hipertensivos, embora os primeiros possam elevar os níveis pressóricos, esse efeito parece não ser significativo em pacientes com hipertensão essencial27 . Em estudo de coorte para avaliar o efeito em curto prazo da administração de AINE sobre a pressão arterial sistólica (PAS) em 110 pacientes em uso de terapia antihipertensiva, o fármaco mais frequente foi o diclofenaco, cuja associação com os inibidores do sistema renina-angiotensina correspondeu a 21,8% das interações 28 .Em inquérito domiciliar para estimar a prevalência de IMP entre os fármacos anti-hipertensivos da Relação Nacional de Medicamentos Essenciais (RENAME), os pares mais encontrados envolveram o AAS em associação com inibidores da IECA7 .…”

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Prevalência de interações medicamentosas potenciais em indivíduos hipertensos acompanhados na estratégia de saúde da família

Andrade

Souza

2018

J Health Biol Sci.

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Introdução: interações medicamentosas potenciais (IMP) podem ocasionar efeitos sinérgicos ou antagônicos, decorrentes da coadministração de fármacos. Entre os fatores associados, destacam-se sexo, idade avançada e polifarmácia, definida como o uso concomitante de cinco ou mais fármacos. Objetivo: estimar a prevalência de IMP envolvendo fármacos utilizados por indivíduos com hipertensão arterial sistêmica (HAS), acompanhados na atenção primária, em São Francisco do Conde, Bahia. Métodos: estudo transversal, cujos participantes tinham idade igual ou superior a 18 anos e diagnóstico de HAS. As variáveis estudadas foram sexo, idade e fármacos prescritos. A produção de dados ocorreu entre novembro/2013 a outubro/2014. As IMP foram classificadas de acordo com início de ação, mecanismo farmacológico, gravidade e documentação na literatura científica, utilizando o banco de dados do software Micromedex® Healthcare Series 2.0. Os dados foram analisados no software Stata® 12.0. Resultados: participaram do estudo 356 indivíduos, com idade média de 57 anos (desvio padrão: 14,2), sendo 75% do sexo feminino. A prevalência de IMP foi 53,4%. Foram prescritos, em média, 3,4 fármacos/indivíduo. A prevalência de polifarmácia foi 29,5%. A idade associou-se significativamente com polifarmácia (42,1% nos idosos; p<0,001) e com ocorrência de IMP (64,5% nos idosos; p<0,001). Do total de 581 IMP, predominaram as decorrentes da associação captopril-hidroclorotiazida (7,6%). Prevaleceram, ainda, IMP com início de ação não especificado (40,6%), mecanismo farmacodinâmico (62,0%), gravidade moderada (85,0%) e com boa documentação na literatura científica (57,8%). Conclusão: considerando a elevada prevalência de polifarmácia e IMP envolvendo anti-hipertensivos, particularmente entre os idosos, recomenda-se que o tratamento com esses fármacos seja cuidadosamente monitorado pela equipe de saúde.

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NSAID–antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?

Cited by 13 publications

References 37 publications

Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis

Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis

Non-steroidal anti-inflammatory drug effects on renal and cardiovascular function: from physiology to clinical practice

Prevalência de interações medicamentosas potenciais em indivíduos hipertensos acompanhados na estratégia de saúde da família

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