Frequency of analgesic use and risk of hypertension among men

Nonnarcotic analgesics are the most commonly used drugs in the United States. To our knowledge, the association between the use of these analgesics, particularly acetaminophen, and the risk of hypertension among men has not been extensively studied.

The association between analgesic use and risk of incident hypertension was analyzed in a prospective cohort analysis of 16 031 male health professionals without a history of hypertension at baseline. Detailed information about the frequency of use of acetaminophen, nonsteroidal anti-inflammatory drugs, and aspirin was gathered at baseline and updated 2 years later. The relative risk of incident hypertension during 4 years of follow-up was analyzed using multivariable proportional hazards regression.

We identified 1968 incident cases of hypertension. After adjusting for multiple potential confounders, men who used acetaminophen 6 to 7 days per week compared with nonusers had a relative risk for incident hypertension of 1.34 (95% confidence interval, 1.00-1.79; P=.01 for trend). This same comparison resulted in relative risks of 1.38 (95% confidence interval, 1.09-1.75; P=.002 for trend) for nonsteroidal anti-inflammatory drugs and 1.26 (95% confidence interval, 1.14-1.40; P<.001 for trend) for aspirin. We observed similar results when the number of pills per week was analyzed rather than frequency of use in days per week.

The frequency of nonnarcotic analgesic use is independently associated with a moderate increase in the risk of incident hypertension. Given the widespread use of these medications and the high prevalence of hypertension, these results may have important public health implications.