Credit: © jsberry / Fotolia

Credit: © jsberry / Fotolia

Ibuprofen can increase blood pressure in arthritis patients

Ibuprofen can increase blood pressure in arthritis patients, according to the latest research from the European Society of Cardiology.

Nonsteroidal anti-inflammatory drugs are the most commonly prescribed painkillers in the world. It is especially recommended for arthritis.

These drugs have warnings about blood pressure increases, but little data is known about these effects. Controlling blood pressure in arthritis and hypertension patients could avoid more than 70,000 deaths from stroke and 60,000 deaths from coronary heart disease each year.

The study press release explained the following methods and results:

Patients were randomised in a 1:1:1 fashion to receive celecoxib (100–200 mg twice a day), ibuprofen (600–800 mg three times a day), or naproxen (375–500 mg twice a day) with matching placebos. The primary endpoint was the change from baseline in 24-hour ambulatory blood pressure after four months.

The investigators found that celecoxib decreased the average systolic blood pressure measured over 24 hours by -0.3 mmHg while ibuprofen and naproxen increased it by 3.7 and 1.6 mmHg, respectively. The resulting difference of -3.9 mmHg between celecoxib and ibuprofen was significant (p=0.009).

Principal investigator Professor Frank Ruschitzka, professor of cardiology and co-head, Department of Cardiology, University Heart Centre, Zurich, Switzerland, said: “PRECISION-ABPM showed differential blood pressure effects between the different NSAIDs, ibuprofen and naproxen, and the COX-2 inhibitor celecoxib. While celecoxib and naproxen produced either a slight decrease (celecoxib) or a relatively small increase (naproxen) in blood pressure, ibuprofen was associated with a significant increase in ambulatory systolic blood pressure of more than 3 mmHg.”

Patients receiving ibuprofen had a 61% higher incidence of de novo hypertension compared to those receiving celecoxib,” said Professor Ruschitzka.

Professor Ruschitzka said: “The current findings suggest that the elevated cardiovascular risk with NSAIDs may be partly due to drug-specific increases in blood pressure. This challenges the widely advocated belief that conventional NSAIDs, like naproxen and ibuprofen, with their higher COX-1 (and thromboxane reducing) effects would provide greater cardiovascular safety than other more COX-2 selective agents, particularly celecoxib.”

He concluded: “PRECISION-ABPM clearly demonstrates that NSAIDs, particularly ibuprofen, may be not as safe as previously thought. Patients should continue to consult their doctor before taking NSAIDs or coxibs and clinicians need to weigh the potential hazards of worsening blood pressure control when considering the use of these agents.” 

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REFERENCES:
1. “Ibuprofen Associated with Blood Pressure Rise in Arthritis Patients at Cardiovascular Risk.” European Society Of Cardiology, Alpha Galileo, 28 Aug. 2017, http://www.alphagalileo.org/ViewItem.aspx?ItemId=178382&CultureCode=en.

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