Study Links Painkillers, Blood Pressure
Women taking daily amounts of non-aspirin painkillers
— such as extra-strength Tylenol — should monitor their
blood pressure, doctors say following a new study suggesting a
link between the drugs and hypertension.
"If you're taking these over-the-counter medications at
high dosages on a regular basis, make sure that you report it
to your doctor and you're checking your blood pressure," said
Dr. Christie Ballantyne, a cardiologist at the Methodist DeBakey
Heart Center in Houston who had no role in the study.
While many popular over-the-counter painkillers have been linked
before to high blood pressure, acetaminophen, sold as Tylenol,
has generally been considered relatively free of such risk.
It is the only one that is not a non-steroidal anti-inflammatory
drug or NSAID, a class of medications the federal government just
required to carry stricter warning labels because of the risk
for heart-related problems. Those include ibuprofen (sold as Advil
and Motrin) and naproxen (sold as Aleve). Many had turned to those
painkillers in the wake of problems with prescription drugs, such
as Vioxx.
However, the new study found that women taking Tylenol were about
twice as likely to develop blood pressure problems. Risk also
rose for women taking NSAIDS other than aspirin.
The research found that aspirin still remains the safest medicine
for pain relief. It has long been known to reduce the risk of
cardiovascular problems and was not included in the government's
requirement for stricter labels for NSAIDs.
The study involved 5,123 women participating in the Nurses Health
Study at Harvard Medical School and Brigham and Women's Hospital
in Boston. None had had high blood pressure when it began.
Results were published online Monday in the American
Heart Association journal Hypertension.
"It certainly sets the basis for more studies," said Dr. Stephanie
Lawhorn, a cardiologist at St. Luke's Mid America Heart Institute
in Kansas City. "Most of the time we think that things like acetaminophen
are fairly safe drugs."
The study found that women ages 34-77 who took an average daily
dose of more than 500 milligrams of acetaminophen — one extra-strength
Tylenol — had about double the risk of developing high blood
pressure within about three years.
Women 51-77 who take more than 400 mg a day of NSAIDS —
equal to say two ibuprofen — had a 78 percent increased risk
of developing high blood pressure over those who didn't take the
drug. Those ages 34-53 had a 60 percent risk increase.
"We are by no means suggesting that women with chronic pain conditions
not receive treatment for their pain," lead author Dr. John Phillip
Forman, of Harvard Medical School and associate physician at Brigham
and Women's Hospital in Boston, said in an e-mail. "By pointing
out risks associated with these drugs, more informed choices can
be made by women and their clinicians."
Previous research linking these drugs to blood pressure problems
did not look at dose.
The results in this study held up even when researchers excluded
women who were taking pills for headaches, something that could
itself be a result of very high blood pressure, said Dr. Gary
Curhan, another study author also of Harvard Medical School.
As for why aspirin didn't raise risk, it might be because "aspirin
has a different effect on blood vessels than NSAIDS and acetaminophen
have," said Dr. Daniel Jones, dean of the school of medicine at
University of Mississippi Medical Center in Jackson.
Reference
Source 102
August
16, 2005
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