The impact of nonsteroidal anti-inflammatory drugs on hypertension: alternative analgesics for patients at risk

摘要: An estimated 25% of the overall population United States and 55% to 60% aged 65 74 years are hypertensive. Many patients with hypertension, particularly elderly patients, also take nonsteroidal anti-inflammatory drugs (NSAIDs), most commonly prescribed analgesic medications in States. It is that as many 20 million 12% > or = 60 taking concurrent NSAIDs antihypertensive medication. This overlap significant, because inhibit eicosanoid synthesis can thus limit effectiveness exert all part their blood-pressure-lowering action through stimulation release. Overviews clinical trial data indicate blood pressure controlled hypertension be raised by 3 6 mm Hg during treatment NSAIDs, which produce a significant increase subsequent stroke, end-stage renal disease, congestive heart failure. The incidence these sequelae increases age. Clinicians should have greater awareness potential impact on control, especially high-risk such those chronic pain uncontrolled hypertension. Unless an NSAID deemed absolutely necessary, clinician consider alternative analgesics do not affect prostaglandin synthesis. These include acetaminophen, tramadol, and, some cases, narcotic analgesics.