Common Painkillers May Cause Hypertension in Men

Middle-aged men who regularly take the widely used pain pills acetaminophen, ibuprofen or aspirin appear to have an elevated risk of developing high blood pressure.

The three drugs are the most commonly used medications in the United States, according to a study published in the Feb. 26 issue of Archives of Internal Medicine.

"People should be aware that these drugs have potential adverse effects," said study senior author Dr. Gary Curhan, a researcher at Brigham & Women's Hospital in Boston. "The risk of bleeding is well-known for aspirin and NSAIDs. I would recommend that individuals limit their use of these medications unless they are clearly indicated. If they have chronic symptoms requiring the use of these drugs, they should discuss alternative treatments with their health-care providers."

Dr. Suzanne Steinbaum, director of the Heart and Vascular Institute at Lenox Hill Hospital in New York City, added: "The thought was that medications like acetaminophen or NSAIDs, or even aspirin, would be safe. This particular study reveals that even these medications when taken regularly (greater than 15 pills per week) can actually increase blood pressure, which may eventually lead to heart disease. In fact, these classes of medications for pain are not as safe as we originally thought."

Two large previous studies had suggested that analgesics might be linked with an increased risk of hypertension, or high blood pressure, but those studies involved women.

Another study found that frequent use of painkillers, including nonsteroidal anti-inflammatory drugs, did not substantially increase a healthy man's risk of developing hypertension.

The new study, however, echoed the findings found in women.

The researchers looked at 16,031 male health professionals without a history of hypertension. The participants provided information about their use of acetaminophen (such as Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen and naproxen), and aspirin. The men, with an average age of 64.6 years, were followed for four years, with 1,968 of them developing hypertension

Those who used acetaminophen six to seven days a week had a 34 percent higher risk of hypertension than men who did not use the drug. Similarly, men who took NSAIDs six or seven days a week had a 38 percent higher risk of hypertension, while those taking aspirin at this frequency had a 26 percent higher risk.

And compared with men who took no pills, those who took 15 or more pills each week had a 48 percent higher risk of hypertension.

All three painkillers may inhibit the effect of chemicals that would normally relax blood vessels and decrease blood pressure, the researchers said.

But more research on the subject needs to be done.

"We have now seen these associations in men and women," Curhan said. "The next steps include finding out if people stop these drugs after years of use, does their blood pressure decrease? Also, not everyone that takes these drugs develops hypertension. We need to identify those at highest risk."

More information

To learn more about hypertension, visit the American Heart Association.