Document Detail


The effect of nonsteroidal anti-inflammatory drugs on blood pressure in patients treated with different antihypertensive drugs.
MedLine Citation:
PMID:  12556654     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension and arthritis are both common diseases in the older age group and require pharmacologic treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) alter renal function if given in high enough doses, reducing renal blood flow and the glomerular filtration rate and causing sodium retention. In salt sensitive subjects, this retention of sodium will cause blood pressure to rise. Salt sensitivity is more common in elderly patients, in diabetics, and in people with renal failure. When most antihypertensive drugs are used, people become salt sensitive, as shown by the additive effect of salt restriction or diuretics on blood pressure response. The responses to dihydropyridine and possibly other calcium channel blocking drugs are not affected to any major extent by sodium intake or by diuretics. Studies are described which indicate that indomethacin elevates blood pressure in elderly people treated with enalapril, but not in people whose blood pressure is controlled with amlodipine or felodipine. It is unclear whether the various NSAIDs have different effects on blood pressure. It is proposed that if the same analgesic effect is achieved with the same amount of cyclooxygenase inhibition, the response will be similar. Aspirin, used in a prophylactic dose, does not inhibit to this extent and does not elevate blood pressure. If elderly people require NSAIDs, it would appear that dihydropyridine calcium channel blocking drugs are more effective at lowering and maintaining blood pressure control and should be one of the drugs used. If patients are on other antihypertensive agents, it is important to monitor blood pressure when a NSAID is added to therapy.
Authors:
Trefor Morgan; Adrianne Anderson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  5     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:    2003 Jan-Feb
Date Detail:
Created Date:  2003-01-30     Completed Date:  2003-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-7     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Le Jacq Communications, Inc.
Affiliation:
Department of Physiology, University of Melbourne, and Hypertension Clinic, ARMC, Heidelberg, Australia. t.morgan@physiology.unimelb.edu.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Amlodipine / adverse effects,  therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*,  therapeutic use
Antihypertensive Agents / adverse effects*,  therapeutic use
Arthritis / drug therapy*
Blood Pressure / drug effects
Drug Interactions
Enalapril / adverse effects,  therapeutic use
Felodipine / adverse effects,  therapeutic use
Female
Humans
Hypertension / drug therapy*
Indomethacin / adverse effects*,  therapeutic use
Kidney / drug effects
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antihypertensive Agents; 53-86-1/Indomethacin; 72509-76-3/Felodipine; 75847-73-3/Enalapril; 88150-42-9/Amlodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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