Painkiller Use in Men May Not Raise Blood Pressure

Frequent use of painkillers, including nonsteroidal anti-inflammatory medications, does not substantially increase a healthy man's risk of developing hypertension, according to a report in the Archives of Internal Medicine.

"It's inconclusive," says Dr. Joel S. Bennett, a spokesman for the American Heart Association who is with the division of hematology/oncology at the University of Pennsylvania School of Medicine.

The findings contradict some previous research and researchers say they will need to continue to look closely at the subject to clarify it.

Past research involving women had suggested there might be a link between pain relievers and hypertension, also known as high blood pressure.

"We don't know what all the answers are," concedes senior author Dr. J. Michael Gaziano, a cardiologist and epidemiologist at Brigham and Women's Hospital in Boston. "We need to better understand what's going on in larger observational studies and randomized trials. We need careful additional study of the question."

Hypertension a Concern Nationwide

Hypertension is a major risk factor for cardiovascular disease, including stroke, heart attack, and heart failure, as well as for kidney disease.

While the authors of this study stated that obesity is probably the major contributing factor to an increased risk for heart disease, they pointed to suspicions that other factors, such as nonsteroidal anti-inflammatory medications (NSAIDs) use, may also play a role.

NSAIDs inhibit production of prostaglandin, which helps regulate blood pressure.

The researchers looked at 8,229 healthy male physicians aged 53 to 97 enrolled in the Physicians' Health Study.

None of the participants had hypertension at the beginning of the trial. All completed detailed questionnaires about use of analgesics (pain relievers) and blood pressure over a six-year period.

After about six years of follow-up, there appeared to be no association between use of painkillers and hypertension. Specifically, the study looked at three types of pain relievers: NSAIDs, aspirin, and the non-NSAID acetaminophen.

When a more detailed analysis was performed, the data indicated there might be a small-to-moderate increase of hypertension risk tied to acetaminophen use, the study found.

The study was funded by the National Institutes of Health (NIH) and by an unrestricted research grant from McNeil Consumer & Specialty Pharmaceuticals, the maker of Tylenol®. It was concerned only with the disease of hypertension and not with transient changes in blood pressure that these drugs can cause.

Jury Still Out on Men vs. Women

Despite the contradictory findings involving women, the study authors do not believe that gender affects reaction to the medications.

"We don't think that women and men are different," says Dr. Gaziano. "A lot of people might conclude incorrectly that men must be different than women, and rather than that conclusion, we don't fully know the whole story of analgesics and their ability to cause hypertension in men or women."

It is possible, however, that pain relievers might heighten the risk of hypertension in certain groups of people.

"These were healthy men and some of those blood pressure changes seen in other trials may be more pronounced in susceptible populations," Dr. Gaziano explains.

Dr. Gaziano believes that short-term use of over-the-counter pain killers is probably safe, as long as the medications are taken as indicated.

"Even if there are going to be any effects on blood pressure, they're going to be transient and are not going to translate into any meaningful risk," he says.

But, he adds, "We really need better [clinical] trial data on the long-term consequences."

Dr. Bennett adds, "This suggests that over the long term, these analgesics are not going to cause hypertension."

High Blood Pressure after 50 Is a Concern

In a follow-up study of 50-year-old men and women, those with normal blood pressure lived longer and spent more years of life free of cardiovascular diseases compared to those with high blood pressure, researchers report in Hypertension: Journal of the American Heart Association.

Men with normal blood pressure survived 7.2 years longer without cardiovascular disease compared to men with high blood pressure, and spent 2.1 fewer years of their lives with cardiovascular disease.

There were similar differences in the women studied. Total life expectancy for people with normal blood pressure was 5.1 years longer in men and 4.9 years longer in women than in people with high blood pressure.

High blood pressure is systolic (top number) pressure of 140 millimeters of mercury (mm Hg) or higher and/or a diastolic (bottom number) pressure of 90 mm Hg or higher.

Prehypertension (previously called “high-normal” blood pressure) is 120-139 mm Hg systolic or 80-89 diastolic. Normal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic.

The analysis was based on 3,128 participants in the Framingham Heart Study; 1,364 men and 1,764 women, who reached age 50 while enrolled in that study.

“Hypertension is associated with more years lived with cardiovascular disease,” says lead author Dr. Oscar Franco, a researcher in the Department of Public Health at Erasmus M.C. University Medical Center in Rotterdam, The Netherlands.

This study is the first report from a large and continuously followed group showing in both sexes the effect of high blood pressure levels on total life expectancy and life expectancy with and without heart disease, heart attack, and stroke, Dr. Franco notes.

He says the association between high blood pressure and shorter life expectancy is stronger than previously estimated.

“This emphasizes the need to improve blood pressure control," he explains.

This study differs from others because researchers analyzed more than one blood pressure reading and examined life expectancy with and without heart disease. The average follow-up of the study participants was 27.5 years.

Dr. Franco urges the public to take action to protect themselves against developing high blood pressure and its harmful consequences.

“Lifestyle modification is important to control blood pressure,” he says. He recommends a heart-healthy diet, regular physical activity, and weight control, as set forth in guidelines from the American Heart Association.

He also urges physicians to focus more on preventing high blood pressure by using all means available to educate their patients, particularly those over age 40.

Always consult your physician for more information.

Powered by Big Medium™

© NewYork-Presbyterian Hospital | Ways to Give
Home | Disclaimer | Sitemap | Privacy Notice | Feedback