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 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.
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."
Always consult your physician for more information.
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