Related Experiment Video
Updated: Jun 1, 2026
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Harmful effects of NSAIDs among patients with hypertension and coronary artery disease
Anthony A Bavry1, Asma Khaliq, Yan Gong
1Department of Medicine, College of Medicine, University of Florida, Gainesville, 32610-0277, USA. bavryaa@medicine.ufl.edu
Insights
Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases adverse cardiovascular events in patients with hypertension and coronary artery disease. This finding highlights potential risks associated with long-term NSAID use in this vulnerable population.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Limited data exists on the safety of chronic nonsteroidal anti-inflammatory drug (NSAID) use in patients with both hypertension and coronary artery disease.
- Hypertension and coronary artery disease are significant risk factors for cardiovascular events.
Purpose of the Study:
- To investigate the association between chronic NSAID use and adverse cardiovascular outcomes in patients with hypertension and coronary artery disease.
Main Methods:
- A post hoc analysis of the INternational VErapamil Trandolapril STudy (INVEST) was conducted.
- Patients with hypertension and coronary artery disease were categorized into chronic NSAID users and nonchronic NSAID users based on self-report at each visit.
- Cox regression analysis was employed to assess the primary composite outcome of all-cause death, nonfatal myocardial infarction, or nonfatal stroke.
Main Results:
- The study included 882 chronic NSAID users and 21,694 nonchronic NSAID users.
- Chronic NSAID use was associated with a significantly higher rate of the primary composite outcome (adjusted hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.19-1.82; P=.0003).
- This increased risk was primarily driven by a significant rise in cardiovascular mortality (adjusted HR 2.26; 95% CI, 1.70-3.01; P<.0001).
Conclusions:
- Chronic self-reported NSAID use is linked to an elevated risk of adverse cardiovascular events in patients with hypertension and coronary artery disease.
- These findings suggest caution regarding long-term NSAID use in this patient population.
Background:
There is limited information about the safety of chronic nonsteroidal anti-inflammatory drugs (NSAIDs) in hypertensive patients with coronary artery disease.
Methods:
This was a post hoc analysis from the INternational VErapamil Trandolapril STudy (INVEST), which enrolled patients with hypertension and coronary artery disease. At each visit, patients were asked by the local site investigator if they were currently taking NSAIDs. Patients who reported NSAID use at every visit were defined as chronic NSAID users, while all others (occasional or never users) were defined as nonchronic NSAID users. The primary composite outcome was all-cause death, nonfatal myocardial infarction, or nonfatal stroke. Cox regression was used to construct a multivariate analysis for the primary outcome.
Results:
There were 882 chronic NSAID users and 21,694 nonchronic NSAID users (n = 14,408 for never users and n=7286 for intermittent users). At a mean follow-up of 2.7 years, the primary outcome occurred at a rate of 4.4 events per 100 patient-years in the chronic NSAID group, versus 3.7 events per 100 patient-years in the nonchronic NSAID group (adjusted hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.19-1.82; P=.0003). This was due to an increase in cardiovascular mortality (adjusted HR 2.26; 95% CI, 1.70-3.01; P<.0001).
Conclusion:
Among hypertensive patients with coronary artery disease, chronic self-reported use of NSAIDs was associated with an increased risk of adverse events during long-term follow-up.
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
01:16Antianginal Drugs: Nitrates and β-Blockers
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...