How does nsaids increase blood pressure

These data were supported by 2 large community studies involving elderly patients. While the mechanism s remain speculative, salt and water retention through several factors operating in parallel, coupled with increased total peripheral vascular resistance, via increased renal endothelin-1 synthesis, are potentially important. Clinicians should strive to avoid excessive use of NSAID treatment and consider well-tolerated therapeutic alternatives, including simple analgesics and physical therapy.

Low-dose aspirin does not interfere with the blood pressure-lowering effects of antihypertensive therapy. J Hypertens. Systematic review of trials of the effect of continued use of oral non-selective NSAIDs on blood pressure and hypertension.

Curr Med Res Opin. Meta-analysis of cyclooxygenase-2 inhibitors and their effects on blood pressure. An updated meta-analysis. Cardiovascular safety of nonsteroidal anti-inflammatory drugs: network meta-analysis. Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The complete database of evidence-based questions and answers is copyrighted by FPIN. Want to use this article elsewhere?

Get Permissions. Read the Issue. Sign Up Now. Aug 15, Issue. Evidence-Based Answer Aspirin does not elevate blood pressure. Enlarge Print Table 1. Table 1. Read the full article. N Engl J Med ; : — Am Heart J ; : — A new equation to estimate glomerular filtration rate. Collaborative overview of randomised trials of antiplatelet therapy—I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients.

Antiplatelet Trialists' Collaboration. BMJ ; : 81 — Fitzgerald GA. Coxibs and cardiovascular disease. Treating osteoarthritis with cyclooxygenasespecific inhibitors: what are the benefits of avoiding blood pressure destabilization? Hypertension ; 45 : 92 — Meta-analysis of cyclooxygenase-2 inhibitors and their effects on blood pressure.

Hypertension ; 43 : — Effect on blood pressure of lumiracoxib versus ibuprofen in patients with osteoarthritis and controlled hypertension: a randomized trial. J Hypertens ; 26 : — Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril.

Am J Hypertens ; 13 : — Influence of non-steroidal anti-inflammatory drugs on renal function and 24h ambulatory blood pressure-reducing effects of enalapril and nifedipine gastrointestinal therapeutic system in hypertensive patients.

J Hypertens ; 13 : — Effects of etoricoxib and comparator nonsteroidal anti-inflammatory drugs on urinary sodium excretion, blood pressure, and other renal function indicators in elderly subjects consuming a controlled sodium diet. J Clin Pharmacol ; 47 : — The effects of cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory therapy on h blood pressure in patients with hypertension, osteoarthritis, and type 2 diabetes mellitus.

Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension ; 39 : — Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial.

Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial.

Celecoxib Long-term Arthritis Safety Study. Effect of celecoxib on cardiovascular events and blood pressure in two trials for the prevention of colorectal adenomas. Circulation ; : — Celecoxib for the prevention of colorectal adenomatous polyps.

Atherosclerosis ; : — Short- and long-term COX-2 inhibition reverses endothelial dysfunction in patients with hypertension. Hypertension ; 42 : — Selective COX-2 inhibition improves endothelial function in coronary artery disease. Celecoxib decreases endothelial tissue factor expression through inhibition of c-Jun terminal NH2 kinase phosphorylation.

The coxibs, selective inhibitors of cyclooxygenase White WB , Campbell P. Blood pressure destabilization on nonsteroidal antiinflammatory agents: acetaminophen exposed?

Bippi H , Frolich JC. Effects of acetylsalicylic acid and paracetamol alone and in combination on prostanoid synthesis in man. Br J Clin Pharmacol ; 29 : — Acetaminophen increases blood pressure in patients with coronary artery disease. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ ; : j Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension.

Systolic Hypertension in Europe Trial Investigators. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens ; 31 : — Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Introduction. Supplementary material. Editor's Choice. Frank Ruschitzka , Frank Ruschitzka. Oxford Academic. Jeffrey S Borer. Henry Krum.

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