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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, USA. wwhite@nso1.uchc.edu
Current Pain and Headache Reports
|January 5, 2008
Summary
Nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors can affect blood pressure and cardiovascular events. Careful use in arthritis patients with stable cardiovascular disorders is advised when benefits outweigh risks.
Area of Science:
- Cardiology
- Pharmacology
- Rheumatology
Background:
- Cardiovascular (CV) effects of NSAIDs and selective COX-2 inhibitors have been extensively evaluated.
- These drugs are commonly used for arthritis and pain management.
Purpose of the Study:
- To review the effects of NSAIDs and COX-2 inhibitors on blood pressure.
- To assess their impact on major adverse cardiovascular events.
Main Methods:
- Analysis of clinical trial databases for NSAIDs and COX-2 inhibitors.
- Evaluation of effects on blood pressure control and CV event incidence.
Main Results:
- NSAIDs and COX-2 inhibitors demonstrated variable effects on blood pressure control in hypertensive patients.
- Incident rates of arrhythmias, congestive heart failure, myocardial infarction, and stroke varied among studies.
Conclusions:
- Nonselective and COX-2 selective NSAIDs can be cautiously used in arthritis patients with hypertension and stable CV disorders.
- Risk-benefit assessment is crucial, excluding patients with congestive heart failure and moderate to severe kidney dysfunction.
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