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Over-the-counter Pain Meds Linked to Hypertension

Breaking News - August 2005 - Week 4

(Aug 24, 2005)

Healthcare in  the News

-- Women who take daily high doses of the over-the-counter painkillers ibuprofen and acetaminophen are more likely to develop high blood pressure than women who do not use the medications, according to a report in Hypertension: Journal of the American Heart Association.

Picture of medication tablets and a stethoscope

Acetaminophen is available in generic form and in a wide number of brand-name products, the best known of which is Tylenol®. Ibuprofen is also sold as a generic and is contained in branded products such as Advil®and Motrin®.

Interestingly, the researchers did not find that aspirin increased women's chances of developing high blood pressure, which is also known as hypertension.

"These drugs [ibuprofen and acetaminophen] are used so frequently and so widely that they could be one reason why the incidence of high blood pressure is so high," says Dr. Gary C. Curhan, an associate professor of medicine at Harvard Medical School, and a member of the research team.

According to the American Heart Association (AHA), nearly one in three US adults has high blood pressure, but because there are no symptoms, nearly one-third of these people do not know they have it.

In fact, states the AHA, many people have high blood pressure for years without knowing it. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure, or kidney failure. This is why high blood pressure is often called the "silent killer." The only way for persons to tell if they have high blood pressure is to have their blood pressure checked.

Studies Find Two Leading Medication Types

The study, which looked at the medical records of more than 5,000 women - ages 34 to 77 - for up to eight years, found that those who took 500 milligrams or more of acetaminophen daily were twice as likely to develop high blood pressure as women who did not take the medication.

Older women, aged 51 to 77, who took an average of 400 milligrams of ibuprofen a day were 80 percent more likely to develop high blood pressure than older women who did not take the medication.

Younger women, aged 34 to 53, who took those daily doses were 60 percent more likely to develop high blood pressure, according to the study.

The Harvard group has reported similar findings in the past. But this study was different, in part, because the participants were asked why they were taking the painkillers, Dr. Curhan says.

Persistent headache can be one of the first signs of high blood pressure, so there was the possibility that the medications were being taken when blood pressure was already high. However, the new study eliminated that possibility, he says.

Link Found, Mechanism Still Uncertain

Dr. Clarence Grim, a professor of clinical medicine at the Medical College of Wisconsin, and an expert on high blood pressure, says, "This is another thing we need to add to the list of items that raise blood pressure, at least for women."

He had some advice for people who take the painkillers frequently:

"Be sure to tell your physician if you are taking them every day, and be sure to keep an eye on your blood pressure," Dr. Grim says. "Even small changes in blood pressure can be very significant."

The mechanism by which the medications could raise blood pressure is uncertain, Dr. Grim explains. There is a "general hypothesis" that they might increase blood levels of sodium by affecting kidney metabolism, he says.

Another possibility, Dr. Curhan says, is that the painkillers may influence blood vessel relaxation. Acetaminophen is known to affect levels of nitric oxide, a substance important in blood vessel control, he says.

Some health experts express concern that the current study was an observational study and that additional types of studies would be needed to confirm the findings.

While the new research involved only women, "we don't have any expectations that it will be different for men," Dr. Curhan says. Men generally use painkillers less than women, and studies of a possible relationship with high blood pressure in men are just beginning, he remarks.

Always consult your physician for more information.

For more information on health and wellness, please visit health information modules on this Web site.

Blood Pressure Defined

Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider, is the force of the blood pushing against the artery walls.

Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts.

One cannot take his own blood pressure unless an electronic blood pressure monitoring device is used. Electronic blood pressure monitors may also measure the heart rate, or pulse.

Two numbers are recorded when measuring blood pressure. The higher number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body.

The lower number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood.

Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of the blood.

High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), high blood pressure for adults is defined as:

140 mm Hg or greater systolic pressure


90 mm Hg or greater diastolic pressure

In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:

120 mm Hg - 139 mm Hg systolic pressure


80 mm Hg - 89 mm Hg diastolic pressure

The new NHLBI guidelines now define normal blood pressure as follows:

less than 120 mm Hg systolic pressure


less than 80 mm Hg diastolic pressure

These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment.

A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.

Always consult your physician for a diagnosis.

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