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Acetaminophen use and risk of myocardial infarction and stroke in a hypertensive cohort

Rachael L Fulton1, Matthew R Walters1, Ross Morton1

  • 1From the Institute of Cardiovascular and Medical Sciences (R.L.F., M.R.W., R.M.T., A.F.D., S.P., G.T.M., J.D.), School of Medicine (R.M., P.A.M.), and West of Scotland Cancer Surveillance Unit (D.S.M.), College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.

Hypertension (Dallas, Tex. : 1979)
|March 25, 2015
PubMed

Insights

Acetaminophen use in hypertensive patients aged 65+ was not linked to increased risk of heart attack or stroke, according to verified prescription data. This study provides crucial evidence on the cardiovascular safety of acetaminophen in this population.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Epidemiology

Background:

  • Previous studies suggested a link between self-reported acetaminophen use and cardiovascular events.
  • Acetaminophen (paracetamol) is a common analgesic, but its cardiovascular safety in hypertensive individuals requires clarification.
  • Lack of randomized trials and studies using verified prescription data for this association.

Purpose of the Study:

  • To investigate the relationship between verified acetaminophen prescription data and the risk of myocardial infarction (heart attack) or stroke.
  • To assess cardiovascular event risk associated with acetaminophen use in patients with hypertension using real-world data.

Main Methods:

  • Retrospective data analysis of 24,496 hypertensive individuals (≥ 65 years) from the UK Clinical Practice Research Datalink over 10 years.
  • Utilized multivariable Cox proportional hazard models and a propensity-matched design to analyze time-dependent acetaminophen exposure.
  • Primary endpoint: myocardial infarction; secondary endpoints: stroke and any cardiovascular event.

Main Results:

  • No statistically significant association was found between acetaminophen exposure and the risk of myocardial infarction (HR 0.98, 95% CI 0.76-1.27).
  • Acetaminophen use was not associated with an increased risk of stroke (HR 1.09, 95% CI 0.86-1.38) or any cardiovascular event (HR 1.17, 95% CI 0.99-1.37).
  • Results remained consistent in propensity-matched samples, separate analyses for men and women, and high-frequency users.

Conclusions:

  • Verified acetaminophen prescription data did not reveal an increased risk of myocardial infarction or stroke in hypertensive patients aged 65 and older.
  • The findings suggest that acetaminophen is likely safe concerning major cardiovascular events in this patient group.
  • This study addresses a critical knowledge gap using robust, real-world prescription data.

Keywords:
acetaminophenhypertension

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