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Cardiovascular risk, hypertension, and NSAIDs
1Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-3940, USA. wwhite@nso1.uchc.edu
Current Rheumatology Reports
|April 18, 2007
Summary
Nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors can impact blood pressure and cardiovascular events. Careful use in hypertensive patients with stable cardiovascular disorders is advised when benefits outweigh risks.
Area of Science:
- Pharmacology
- Cardiology
- Rheumatology
Background:
- Extensive evaluation of cardiovascular (CV) effects of NSAIDs and selective COX-2 inhibitors has occurred.
- NSAIDs and COX-2 inhibitors are commonly used for pain and inflammation management.
Purpose of the Study:
- To review the effects of NSAIDs and COX-2 inhibitors on blood pressure.
- To examine the impact of these drugs on major adverse cardiovascular events.
Main Methods:
- Analysis of clinical trial databases.
- Review of studies evaluating blood pressure control and CV events.
Main Results:
- NSAIDs and COX-2 inhibitors demonstrated variable effects on blood pressure control in hypertensive patients.
- Incident rates for arrhythmias, congestive heart failure, myocardial infarction, and stroke varied among treated patients.
- Both nonselective and COX-2 selective NSAIDs showed potential CV and gastrointestinal risks.
Conclusions:
- NSAIDs and COX-2 inhibitors can be used cautiously in arthritis patients with hypertension and stable CV disorders.
- Exclusion criteria include congestive heart failure and moderate to severe kidney dysfunction.
- Clinical benefit of anti-inflammatory therapy must be weighed against potential CV and gastrointestinal risks.
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