Nonsteroidal anti-inflammatory drugs and blood pressure in an elderly population

Short-term clinical studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) may interfere with the effectiveness of antihypertensive therapies. We studied the joint effects of these two classes of drugs among subjects participating in the cross-sectional baseline interview from a population-based cohort study of community-dwelling elderly.

Blood pressure was recorded by interviewers using a standard sphygmomanometer after at least 5 minutes in the sitting position. Two recordings were made in rapid succession, using the first and fifth Korotkoff sounds. The second recording was used for this study. From respondents' medication container labels, interviewers recorded the name and dosage regimen of each medication used during the preceding two weeks.

Persons on antihypertensive therapy taking NSAIDs had systolic blood pressures approximately 5 mmHg higher than those not taking NSAIDs, and were more likely to have systolic blood pressure above 140 mmHg (odds ratio = 2.19, 95% confidence interval 1.33, 3.61). These findings could not be explained by differences between NSAID users and nonusers in age, relative weight, or the type or dose of antihypertensive regimen. No significant effects of NSAIDs were seen for diastolic blood pressure or among persons not taking antihypertensive drugs. When analyses were restricted to non-indomethacin NSAID use, the findings were unchanged.

These findings suggest that NSAID use may be an important community reason for loss of pharmacologic control of hypertension.