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Sodium-containing acetaminophen and cardiovascular outcomes in individuals with and without hypertension

Chao Zeng1,2,3, Lynn Rosenberg4, Xiaoxiao Li5

  • 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.

European Heart Journal
|February 24, 2022
PubMed

Insights

Sodium-containing acetaminophen increases cardiovascular disease (CVD) and mortality risks in both hypertensive and non-hypertensive individuals. Avoid unnecessary sodium intake from medications like acetaminophen.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Public Health

Background:

  • High sodium intake is linked to cardiovascular disease (CVD) and mortality in hypertensive individuals.
  • Previous research on non-hypertensive individuals has yielded inconclusive results regarding sodium intake risks.

Purpose of the Study:

  • To compare the risks of incident CVD and all-cause mortality between sodium-containing and non-sodium-containing acetaminophen initiators.
  • To analyze these risks based on a patient's hypertension history.

Main Methods:

  • Two cohort studies were conducted using The Health Improvement Network database.
  • Marginal structural models with inverse probability weighting adjusted for time-varying confounders.
  • Outcomes included incident CVD (myocardial infarction, stroke, heart failure) and all-cause mortality over 1-year follow-up.

Main Results:

  • Among hypertensive individuals, sodium-containing acetaminophen initiators had a 1.59 HR for CVD (95% CI 1.32-1.92).
  • Among non-hypertensive individuals, the HR for CVD was 1.45 (95% CI 1.18-1.79).
  • Similar risk increases were observed for specific CVD outcomes and all-cause mortality in both groups.

Conclusions:

  • Initiating sodium-containing acetaminophen is associated with elevated risks of CVD and all-cause mortality, irrespective of hypertension status.
  • The findings underscore the importance of avoiding unnecessary sodium intake from medications.
  • Patients should be mindful of sodium content in over-the-counter medications like acetaminophen.
Abstract

Keywords:
AcetaminophenCardiovascular diseaseMortalitySodium

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