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[Nonsteroidal antirheumatics and hypertension]
Kresimir Galesić1, Bojan Jelaković
1Odjel za nefrologiju, Klinika za unutarnje bolesti, Klinicka bolnica Dubrava, Zagreb. kresog@kbd.hr
Lijecnicki Vjesnik
|May 27, 2011
Summary
Nonsteroidal anti-inflammatory drugs (NSAID) can elevate blood pressure by blocking prostaglandin synthesis, leading to fluid retention. This effect impacts both healthy and hypertensive individuals, increasing cardiovascular risk.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Internal Medicine
Context:
- Nonsteroidal anti-inflammatory drugs (NSAID) are widely prescribed, accounting for 4-9% of all prescriptions.
- NSAID use is associated with common and significant side effects, impacting public health.
- Understanding NSAID's cardiovascular effects is crucial due to their prevalence.
Purpose:
- To summarize the impact of NSAID on blood pressure and cardiovascular risk.
- To elucidate the mechanisms by which NSAID affect blood pressure.
- To review NSAID interactions with various antihypertensive medications.
Summary:
- Nonselective NSAID (COX-1 and COX-2 inhibitors) and selective COX-2 inhibitors (coxibes) can increase blood pressure by 5-10 mmHg.
- The primary mechanism involves the blockage of prostaglandin synthesis, resulting in sodium and fluid retention.
- NSAID can increase blood pressure in normotensive and hypertensive individuals, and interact with certain antihypertensive drugs, though not typically calcium channel blockers. Aspirin generally does not increase blood pressure.
Impact:
- NSAID-induced hypertension poses a significant public health concern due to widespread use.
- Awareness of NSAID's blood pressure effects is vital for clinicians managing patients, especially those with pre-existing hypertension.
- This information aids in optimizing antihypertensive therapy in patients concurrently using NSAID.
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