Acetaminophen, ibuprofen, and aspirin — among the most-used medications in the U.S. — may increase the risk for hypertension through a variety of mechanisms. All three analgesics may inhibit vasodilatory prostaglandins; acetaminophen may increase oxidative stress; nonsteroidal anti-inflammatory drugs may increase renal sodium reabsorption; and both acetaminophen and NSAIDs may impair endothelial function. In a prospective observational study using data from the Health Professionals Follow-Up Study, researchers assessed this relation among about 16,000 men (average age, 65) with no history of hypertension. Participants reported how often they used acetaminophen, NSAIDs, and aspirin at baseline and at year 2.
During a mean follow-up of 4 years, participants also reported whether they had been diagnosed with hypertension. Compared with nonusers, those who took acetaminophen, NSAIDs, or aspirin 6 or 7 days a week had significantly elevated relative risks for incident hypertension of 1.34, 1.38, and 1.26, respectively; the analysis controlled for a number of potential confounders including age, body-mass index, physical activity, smoking, and family history.
Comment: This observational study found that the frequent use of acetaminophen, NSAIDs, or aspirin was associated with incident hypertension and confirms previously published findings from the Nurses’ Health Study.
— Jamaluddin Moloo, MD, MPH
Published in Journal Watch General Medicine March 20, 2007
Near-daily use of nonnarcotic analgesics, including acetaminophen, confers a moderate increase in the risk for developing hypertension, researchers report in the current Archives of Internal Medicine.
The study group comprised some 16,000 men with an average age of 65 and no history of hypertension. They were subjects in the Health Professionals Follow-up Study. Participants reported the frequency of their use of acetaminophen, NSAIDS, and aspirin at baseline; on two questionnaires over the subsequent 4 years they also reported whether they'd been diagnosed with hypertension.
Compared with nonusers, those who took NSAIDS, aspirin, or acetaminophen 6 or 7 days a week had a multivariable relative risk for incident hypertension of 1.38, 1.26, and 1.34, respectively. The authors suggest the acetaminophen link might be mediated through vasodilatory prostaglandins, oxidative stress, and endothelial function.
The authors say their findings echo others' and "suggest that these agents be used with greater caution."