November 2007

Pain pills linked to elevated blood pressure in men

Men who regularly take commonly available and widely used pain relievers may have an increased risk of high blood pressure compared with those who do not use these medications, according to a report in the Feb. 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Acetaminophen, ibuprofen and aspirin are among the most commonly used drugs in the United States, according to background information in the article. Two large studies have recently suggested that pain‑relieving medications (analgesics) may be associated with an increased risk of hypertension (high blood pressure) in women. However, the association has not been extensively studied in men.

John P. Forman, M.Sc, MD, of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues followed a total of 16,031 male health professionals (average age 64.6 years) who did not have a history of high blood pressure. The men were asked in 2000 and again in 2002 about whether and how often they used three types of pain relievers: acetaminophen, non‑steroidal anti‑inflammatory drugs (NSAIDs, which include ibuprofen and naproxen) and aspirin. They were also asked to report if their physician had diagnosed them with hypertension.

Over four years of follow‑up, 1,968 men developed hypertension. Compared with men who did not take analgesics, those who took acetaminophen six or seven days a week had a 34 percent higher risk of hypertension. Those who took NSAIDs six or seven days a week had a 38 percent higher risk and those who took aspirin six or seven days a week had a 26 percent higher risk. The researchers also looked at the total number of pain‑relieving pills men took each week, regardless of type. Compared with men who took no pills, those who took 15 or more pills each week had a 48 percent higher risk of hypertension.

All three types of analgesics may inhibit the effects of chemicals that relax the blood vessels, decreasing blood pressure, the authors suggest. Acetaminophen also may impair cell functioning through high levels of oxygen (oxidative stress) or reduce the proper functioning of blood vessel lining.

"These data add further support to the hypothesis that non‑narcotic analgesics independently elevate the risk of hypertension," the authors write. "Given their common consumption and the high prevalence of hypertension, our results may have substantial public health implications and suggest that these agents be used with greater caution. The contribution of non‑narcotic analgesics to the hypertension disease burden merits further study."

Source: American Medical Association (Arch Intern Med. 2007;167:394‑399.)