Original scientific paper
Prohypertensive Effects of Non-Steroidal Anti-Inflammatory Drugs are Mostly Due to Vasoconstriction
Ivančica Pavličević
Milan Glavaški
Mirjana Rumboldt
Zvonko Rumboldt
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) have prohypertensive effects and blunt the effects of many antihypertensives.
The mechanism of this interaction is still not understood enough. The objective of this investigation was
to determine the level of prohypertensive effects of two NSAIDs (ibuprofen, piroxicam) and paracetamol, co-prescribed
with two antihypertensive drugs (lisinopril + hydrochlorothiazide, amlodipine), and to improve the understanding of
this interaction. A prospective clinical trial, conducted in a Croatian family practice, included 110 already treated hypertensive
patients, aged 56–85 years; 50 control patients and 60 patients who were also taking NSAIDs for osteoarthritis
treatment. The antihypertensive regimens remained the same during this study, while NSAIDs and paracetamol were
crossed-over in three monthly periods. Blood pressure, body weight, serum creatinine, potassium, sodium, diuresis and
24 h urinary sodium excretion were followed-up. In the lisinopril/hydrochlorothiazide subgroup, both ibuprofen and
piroxicam elevated mean arterial pressure by 8.9–9.5% (p<0.001). Body weight increased significantly in the lisinopril/
hydrochlorothiazide + piroxicam subgroup only, while creatinine, urinary output and electrolyte values did not change
appreciably in any of the subgroups. NSAID’s prohypertensive effects seem to be mostly due to vasoconstriction and, to a
minor degree, to volume expansion, since no marked changes in body weight, urinary output, serum creatinine or serum/
urinary electrolyte profile were observed.
Keywords
antihypertensive drugs; NSAIDs; interaction; vasoconstriction
Hrčak ID:
72179
URI
Publication date:
30.9.2011.
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